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Individual

MRS. MARISSA CAROL HYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGACNP-BC

Contact information

Practice address
134 MEDICAL PARK RD STE 200, MOORESVILLE, NC 28117-8527
(980) 302-7800
(980) 302-7805
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(980) 302-7800
(980) 302-7805

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5015825
NC
363LA2100X
Acute Care Nurse Practitioner
2019015811
NC

Other

Enumeration date
05/28/2021
Last updated
03/09/2023
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