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Physician Compare National (NPI:1710326160)

HEALTHCARE PROVIDER: KAREN G HATHAWAY FNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1710326160
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 8123260593
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20130814000614
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name HATHAWAY
Individual professional last name
Provider First Name KAREN
Individual professional first name
Provider Middle Name G
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2012
Individual professional's medical school graduation year
Primary Specialty NURSE PRACTITIONER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 403 PRINCETON RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 1
Group Practice or individual's line 2 address
City JOHNSON CITY
Group Practice or individual's city
State TN
Group Practice or individual's state
Zip Code 376012040
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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