Individual
SHELLY LAVON HATFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8303 DODGE ST, OMAHA, NE 68114-4108
(402) 354-4000
Mailing address
7822 DAVENPORT ST, OMAHA, NE 68114-3629
(402) 391-4855
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100890
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
278455
MEDICARE
—
01
—
P00178261
RR MEDICARE
—
Enumeration date
09/29/2006
Last updated
03/10/2017
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