Provider Demographics
NPI:1619113966
Name:HIATT, EVE SEVIER (PHD, MSN, WHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:EVE
Middle Name:SEVIER
Last Name:HIATT
Suffix:
Gender:F
Credentials:PHD, MSN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40212-1033
Mailing Address - Country:US
Mailing Address - Phone:502-774-8631
Mailing Address - Fax:502-778-3499
Practice Address - Street 1:2215 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40212-1033
Practice Address - Country:US
Practice Address - Phone:502-772-8631
Practice Address - Fax:502-772-3489
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1089475163W00000X
KY4777P363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0538593Medicare PIN
KY00714050Medicare PIN
KY0538794Medicare PIN
KY0795651Medicare PIN
KY06337758Medicare PIN
KY00640009Medicare PIN
KY0538694Medicare PIN