Provider Demographics
NPI:1306833884
Name:HATTON, SHARYN APRIL (CNP)
Entity Type:Individual
Prefix:
First Name:SHARYN
Middle Name:APRIL
Last Name:HATTON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 S PATTERSON BLVD
Mailing Address - Street 2:STE 210
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2684
Mailing Address - Country:US
Mailing Address - Phone:937-208-9090
Mailing Address - Fax:937-208-9075
Practice Address - Street 1:1222 S PATTERSON BLVD
Practice Address - Street 2:STE 210
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2684
Practice Address - Country:US
Practice Address - Phone:937-208-9090
Practice Address - Fax:937-208-9075
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3007605Medicaid
OHNP21225Medicare PIN