Provider Demographics
NPI:1285834317
Name:HYATT, DOROTHY LORRAINE (RN)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:LORRAINE
Last Name:HYATT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:LORRAINE
Other - Last Name:ADCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:819 WATER ST
Mailing Address - Street 2:STE 300
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-5333
Mailing Address - Country:US
Mailing Address - Phone:830-792-3300
Mailing Address - Fax:830-792-5771
Practice Address - Street 1:511 E NORTH ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4247
Practice Address - Country:US
Practice Address - Phone:830-625-7359
Practice Address - Fax:830-625-7364
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX563037163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX563037OtherRN LICENSE