Provider Demographics
NPI:1174926182
Name:HATCHER, AMELIA DENISE
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:DENISE
Last Name:HATCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 OVERSTREET WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-4333
Mailing Address - Country:US
Mailing Address - Phone:614-564-9777
Mailing Address - Fax:
Practice Address - Street 1:383 OVERSTREET WAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-4333
Practice Address - Country:US
Practice Address - Phone:614-564-9777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-04
Last Update Date:2014-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCPR374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide