Healthcare Provider Details

I. General information

NPI: 1023265741
Provider Name (Legal Business Name): PATRICIA ANN HYATT RRT, CPFT, EMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA KINNAMON CCPT, CRT

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 JEFFERSON AVE
MEMPHIS TN
38104-2127
US

IV. Provider business mailing address

1030 JEFFERSON AVE
MEMPHIS TN
38104-2127
US

V. Phone/Fax

Practice location:
  • Phone: 901-523-8990
  • Fax: 901-577-7286
Mailing address:
  • Phone: 901-523-8990
  • Fax: 901-577-7286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberB1379407
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRRT0000000355
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: