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General NPI Number Information
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NPI Number | 1447222930
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Entity Type | Individual
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Provider Name | SHARI JEAN HIATT PA
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Gender | Female
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 110 SHEEP SPRINGS RD
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City | JEMEZ PUEBLO
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State | NM
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Zip | 87024-0731
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Country | US
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Telephone | 575-834-7413
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Fax | 575-834-3081
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Provider Business Mailing Address
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Address Line | UNMH FAMILY PRACTICE 24
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City | ALBUQUERQUE
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State | NM
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Zip | 87131-3630
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Country | US
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Telephone | 505-272-1734
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Fax | 928-774-6687
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2022-0103
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3535
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0303P
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA2022-0103
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License Number State | NM
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