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Individual

MS. MARIE HIATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
700 W 7TH ST, MC COOK, NE 69001-3079
(308) 345-2510
Mailing address
700 W 7TH ST, MC COOK, NE 69001-3079
(308) 345-2510

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
22912
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
22912
NE
Enumeration date
06/07/2021
Last updated
06/07/2021
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