Healthcare Provider Details

I. General information

NPI: 1528481181
Provider Name (Legal Business Name): CATHERINE ELIZABETH HYATT CRNA, DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2014
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HALY HO DR
CANDLER NC
28715
US

IV. Provider business mailing address

30 HALY HO DR
CANDLER NC
28715-8341
US

V. Phone/Fax

Practice location:
  • Phone: 865-771-1611
  • Fax:
Mailing address:
  • Phone: 865-771-1611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number272947
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number5050
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: