Provider Demographics
NPI:1679399190
Name:HATCHETT, CAMRIN CENBRIA
Entity type:Individual
Prefix:MS
First Name:CAMRIN
Middle Name:CENBRIA
Last Name:HATCHETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3259 TYLER ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-2149
Mailing Address - Country:US
Mailing Address - Phone:612-402-7197
Mailing Address - Fax:
Practice Address - Street 1:3259 TYLER ST NE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-2149
Practice Address - Country:US
Practice Address - Phone:612-402-7197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-30
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide