Provider Demographics
NPI:1801059449
Name:HYATT, CHRYSTAL GAYLE (NP)
Entity type:Individual
Prefix:MS
First Name:CHRYSTAL
Middle Name:GAYLE
Last Name:HYATT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:322 EAGLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:AL
Mailing Address - Zip Code:35761-9025
Mailing Address - Country:US
Mailing Address - Phone:256-698-5907
Mailing Address - Fax:
Practice Address - Street 1:700 W MARKET ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2457
Practice Address - Country:US
Practice Address - Phone:256-233-9151
Practice Address - Fax:337-262-7434
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-094557363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner