Provider Demographics
NPI:1104958404
Name:HATCH, JUDY (RN, MSN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:
Last Name:HATCH
Suffix:
Gender:F
Credentials:RN, MSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01036-0096
Mailing Address - Country:US
Mailing Address - Phone:413-566-3635
Mailing Address - Fax:
Practice Address - Street 1:453 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMPDEN
Practice Address - State:MA
Practice Address - Zip Code:01036-9682
Practice Address - Country:US
Practice Address - Phone:413-532-9446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA112069163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1529994Medicaid