Provider Demographics
NPI:1891045217
Name:HIATT, ALISON ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:ELIZABETH
Last Name:HIATT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:E
Other - Last Name:MIZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:511 S SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4145
Mailing Address - Country:US
Mailing Address - Phone:785-452-4860
Mailing Address - Fax:785-452-4878
Practice Address - Street 1:511 S SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4145
Practice Address - Country:US
Practice Address - Phone:785-452-4860
Practice Address - Fax:785-452-4878
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS75779363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200969310BMedicaid
KS75779OtherPERMANENT STATE LICENSE