Provider Demographics
NPI:1831706779
Name:HATLEY, NEKOL ANTOINETTE (PMHNP)
Entity type:Individual
Prefix:
First Name:NEKOL
Middle Name:ANTOINETTE
Last Name:HATLEY
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 CREEKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-3403
Mailing Address - Country:US
Mailing Address - Phone:214-875-0111
Mailing Address - Fax:
Practice Address - Street 1:23505 E APPLEWAY AVE STE 200
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-6003
Practice Address - Country:US
Practice Address - Phone:509-661-5410
Practice Address - Fax:509-420-9867
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX747757163WP0808X
WA61109123363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health