Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 149026 | WI |
NPI | 1033872643 |
---|---|
Provider Name | Johanna Janet Hatch |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53704-5341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2021 |
Last Update Date | 04/01/2022 |