Individual
DR. KRISTEN HATHCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, NREMT
Contact information
Practice address
1450 SE 50 RD, ELLINWOOD, KS 67526-9268
(620) 450-6275
Mailing address
1450 SE 50 RD, ELLINWOOD, KS 67526-9268
(620) 450-6275
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
53003
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53003
KBEMS
KS
01
—
72667
BEMS
MO
01
—
E3181012
NREMT
—
Enumeration date
08/14/2020
Last updated
08/14/2020
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