Provider Demographics
NPI:1427339167
Name:HATCH, ALEXIS STORY (FNP)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:STORY
Last Name:HATCH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 E VILLA THERESA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-1280
Mailing Address - Country:US
Mailing Address - Phone:603-475-2616
Mailing Address - Fax:
Practice Address - Street 1:3933 E EDNA AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2127
Practice Address - Country:US
Practice Address - Phone:602-569-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA289480163W00000X
NH064600-21163W00000X
MA8158246Z00000X
AZ291335363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other