Provider Demographics
NPI:1417953027
Name:HATT, NICOLE L (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:L
Last Name:HATT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:892 E CHICAGO ST
Mailing Address - Street 2:SUITE I
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-2063
Mailing Address - Country:US
Mailing Address - Phone:517-278-2519
Mailing Address - Fax:517-753-5912
Practice Address - Street 1:892 E CHICAGO ST
Practice Address - Street 2:SUITE I
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2063
Practice Address - Country:US
Practice Address - Phone:517-278-2519
Practice Address - Fax:517-753-5912
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0A20023OtherBCBSM
VAU99196Medicare UPIN
VA004167C60Medicare ID - Type UnspecifiedMEDICARE