Provider Demographics
NPI:1174494033
Name:HATCHEW, JACLYNN MARIE (MS, RD)
Entity type:Individual
Prefix:
First Name:JACLYNN
Middle Name:MARIE
Last Name:HATCHEW
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:JACKIE
Other - Middle Name:MARIE
Other - Last Name:HATCHEW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, RD
Mailing Address - Street 1:2550 E RIVER RD UNIT 4103
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-9507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2550 E RIVER RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-9500
Practice Address - Country:US
Practice Address - Phone:231-580-5370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered