Provider Demographics
NPI:1154305589
Name:HIATT, CONNIE MARIE (APRN-C)
Entity Type:Individual
Prefix:MS
First Name:CONNIE
Middle Name:MARIE
Last Name:HIATT
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Gender:F
Credentials:APRN-C
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:MADIGAN HEALTHCARE SYSTEM
Mailing Address - Street 2:9040 JACKSON AVE
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1100
Mailing Address - Country:US
Mailing Address - Phone:253-968-1290
Mailing Address - Fax:866-335-2769
Practice Address - Street 1:MADIGAN HEALTHCARE SYSTEM
Practice Address - Street 2:9040 JACKSON AVE
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-968-1290
Practice Address - Fax:866-335-2769
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2011-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAAP60120158363LF0000X
WARN60120025163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse