Provider Demographics
NPI:1366040354
Name:HATCH, JAIME E
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:E
Last Name:HATCH
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 1:86374 PEEPLES RD
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-3387
Mailing Address - Country:US
Mailing Address - Phone:904-415-2930
Mailing Address - Fax:
Practice Address - Street 1:86374 PEEPLES RD
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-3387
Practice Address - Country:US
Practice Address - Phone:904-415-2930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances