Provider Demographics
NPI:1871918540
Name:HATCHER, MEGAN ELIZABETH (CPNP)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:HATCHER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MS
Other - First Name:MEGAN
Other - Middle Name:ELIZABETH
Other - Last Name:WILDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:4201 ST. ANTOINE - UHC 5D - MAILBOX #226
Mailing Address - Street 2:UNIVERSITY PEDIATRICIANS
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2153
Mailing Address - Country:US
Mailing Address - Phone:313-745-4405
Mailing Address - Fax:313-966-0665
Practice Address - Street 1:3901 BEAUBIEN
Practice Address - Street 2:CHILDREN'S HOSPITAL OF MI
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-0113
Practice Address - Fax:313-993-7166
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704260271363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics