MEDICARE: TRACY HATFIELD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3747P1801X	Personal Care Attendant
2	376J00000X	Homemaker
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1023612710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY HATFIELD

Provider Business Mailing Address
First Line	:	394 HAWTHORNE AVE
Second Line	:
City	:	LONDON
State	:	OH
Zip	:	43140-1154
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	394 HAWTHORNE AVE
Second Line	:
City	:	LONDON
State	:	OH
Zip	:	43140-1154
Country	:	US
Telephone Number	:	740-500-2023
Fax Number	:

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

Provider Enumeration Date	:	11/24/2020
Last Update Date	:	11/24/2020

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Directions to “ TRACY HATFIELD ” Practice Location

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