Basic Information
Provider Information
NPI: 1609451277
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HATTON
FirstName: PATRICIA
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14690 SPRING HILL DR STE 305
Address2:  
City: SPRING HILL
State: FL
PostalCode: 346098102
CountryCode: US
TelephoneNumber: 3522775348
FaxNumber: 3526062857
Practice Location
Address1: 13220 BELCHER RD S UNIT 11
Address2:  
City: LARGO
State: FL
PostalCode: 337731678
CountryCode: US
TelephoneNumber: 7275332242
FaxNumber: 7275332252
Other Information
ProviderEnumerationDate: 03/15/2021
LastUpdateDate: 08/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LG0600XAPRN11011912FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology

No ID Information.


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