MEDICARE: ERIN HATCH RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WG0000X	General Practice Registered Nurse	176738	WI

General Provider Information

NPI Number	:	1477210391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN HATCH RN

Provider Business Mailing Address
First Line	:	575 SOMERSET DR
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54301-2723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	575 SOMERSET DR
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54301-2723
Country	:	US
Telephone Number	:	920-819-3253
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2021
Last Update Date	:	11/27/2021

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