Basic Information
| Provider Information | |||||||||
| NPI: | 1629275011 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HATCHER | ||||||||
| FirstName: | BEVERLY | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | RNFA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1945 SCOTTSVILLE RD STE B2 PMB 137 | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421045836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707820434 | ||||||||
| FaxNumber: | 2707820564 | ||||||||
| Practice Location | |||||||||
| Address1: | 1725 ASHLEY CIR STE 211 | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421045820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707820434 | ||||||||
| FaxNumber: | 2707820564 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 1051150 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.