Healthcare Provider Details

I. General information

NPI: 1891045217
Provider Name (Legal Business Name): ALISON ELIZABETH HIATT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISON E MIZE APRN

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 S SANTA FE AVE
SALINA KS
67401-4145
US

IV. Provider business mailing address

511 S SANTA FE AVE
SALINA KS
67401-4145
US

V. Phone/Fax

Practice location:
  • Phone: 785-452-4860
  • Fax: 785-452-4878
Mailing address:
  • Phone: 785-452-4860
  • Fax: 785-452-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number75779
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number75779
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: