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General NPI Number Information
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NPI Number | 1578544409
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Entity Type | Individual
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Provider Name | MARY MOTLEY HATCHETT A-GNP
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Gender | Female
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 10926 DAVID TAYLOR DR STE 120S
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City | CHARLOTTE
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State | NC
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Zip | 28262-1293
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Country | US
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Telephone | 336-706-6614
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Fax | 336-450-1846
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Provider Business Mailing Address
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Address Line | 10926 DAVID TAYLOR DR STE SUITE120
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City | CHARLOTTE
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State | NC
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Zip | 28262-1293
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Country | US
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Telephone | 336-706-6614
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Fax | 336-450-1846
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 600053
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License Number State | NC
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