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General NPI Number Information
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NPI Number | 1285240648
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Entity Type | Individual
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Provider Name | STEPHANIE WILLIAMS HATCH AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 3920A BRIDGE RD STE 204
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City | SUFFOLK
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State | VA
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Zip | 23435-1117
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Country | US
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Telephone | 757-983-0351
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Fax | 757-510-9218
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Provider Business Mailing Address
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Address Line | 3920A BRIDGE RD STE 204
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City | SUFFOLK
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State | VA
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Zip | 23435-1117
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Country | US
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Telephone | 757-983-0351
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Fax | 757-510-9218
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024180183
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 0024180183
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License Number State | VA
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