Provider Demographics
NPI:1710430533
Name:HYATT, AMANDA (RRT, RPSGT, CCSH)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:HYATT
Suffix:
Gender:F
Credentials:RRT, RPSGT, CCSH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 RIVER OAKS DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9530
Mailing Address - Country:US
Mailing Address - Phone:601-326-2599
Mailing Address - Fax:601-933-0852
Practice Address - Street 1:1040 RIVER OAKS DR
Practice Address - Street 2:SUITE 103
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9530
Practice Address - Country:US
Practice Address - Phone:601-326-2599
Practice Address - Fax:601-933-0852
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS8822225500000X
MS018225500000X
MS805225500000X
MSRCP1394227800000X, 227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified