Provider Demographics
NPI:1245384874
Name:HATFIELD, TINA THOMA (RN)
Entity Type:Individual
Prefix:MISS
First Name:TINA
Middle Name:THOMA
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 RAMHORN
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5429
Mailing Address - Country:US
Mailing Address - Phone:254-702-3425
Mailing Address - Fax:
Practice Address - Street 1:18500 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1110
Practice Address - Country:US
Practice Address - Phone:254-702-3425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX686580163WX0002X
TX1036008363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk