Individual
MELANIE ANN HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
206 S JEFFERSON ST, UNIT 2, LOCKPORT, IL 60441-2934
(331) 245-9096
Mailing address
206 S JEFFERSON ST, UNIT 2, LOCKPORT, IL 60441-2934
(331) 245-9096
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041445205
IL
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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