Provider Demographics
NPI:1265243687
Name:HIATT, SUSAN KAY
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:KAY
Last Name:HIATT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2738 I ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-1548
Mailing Address - Country:US
Mailing Address - Phone:402-672-3318
Mailing Address - Fax:
Practice Address - Street 1:2738 I ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-1548
Practice Address - Country:US
Practice Address - Phone:402-672-3318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider