MR. JACKIE DALE HATTEN JR. (NPI# 1639607732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639607732 |
| Entity Type | Individual |
| Full Name | MR. JACKIE DALE HATTEN JR. |
| Credential | ARNP |
| Practice Address |
500 N West Shore Blvd Ste 635 Tampa FL 33609-1910 |
| Practice Telephone | 8135139493 |
| Practice Fax Number | 9045623317 |
| Mailing Telephone | 8135139493 |
| Mailing Fax Number | 9045623317 |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2018-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP3419772 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | EMPLOYER DOSE NOT TAKE INSURANCE | 1639607732 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1918 Blanding Blvd, Jacksonville, FL 322103202 | 9043896954 | 9045263317 |
| Street Address |
500 N WEST SHORE BLVD STE 635 |
| City | TAMPA |
| State | FL |
| Zip Code | 33609-1910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427521970 | Kampsen Hearing LLC | Audiologist | 310 South Macdill Avenue, Suite 202, Tampa, FL 33609 | 2019-01-08 |
| 1629557319 | Priscilla Luna-mitchum | Physical Therapist | 2700 W M.l.k Jr Blvd, Suite 300, Tampa, FL 33609 | 2018-08-13 |
| 1043735657 | Mary Elizabeth Osbach | Registered Nurse | 3211 W Swann Ave, Unit 1106, Tampa, FL 33609 | 2017-08-04 |
| 1497275317 | Jeilyn M Jimenez | Developmental Therapist | 550 N Reo Street, Tampa, FL 33609 | 2017-06-21 |
| 1033658513 | Adela Reeb | Specialist/Technologist | 909 North Dale Mabry Hwy, Tampa, FL 33609 | 2017-02-17 |
| 1033561261 | Abigail Marie Richardson | Developmental Therapist | 555 North Reo Street, Tampa, FL 33609 | 2016-07-12 |
| 1275992448 | Jennifer Stich | Behavioral Analyst | 3210 W De Leon St # B, Tampa, FL 33609 | 2016-02-16 |
| 1154711505 | Health E Systems, LLC | Transportation Broker | 5100 W. Lemon Street, Suite 311, Tampa, FL 33609 | 2015-01-23 |
| 1619375292 | Healthexchange Systems, LLC | Home Health | 5100 West Lemon Street, Suite 311, Tampa, FL 33609 | 2014-12-12 |
| 1538567458 | Calvin Harrison Iv | Occupational Therapist | 600 N. Westshore Blvd, Suite 600, Tampa, FL 33609 | 2014-12-09 |
| Find all providers in zip 33609 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157669 | Lotaya Anneka Hinds | Nurse Practitioner | 2105 E 115th Ave, Tampa, FL 33612-6121 | 2020-09-03 |
| 1821608324 | Racquel Creus | Nurse Practitioner | 20530 Colonial Isle Dr Unit 202, Tampa, FL 33647-3701 | 2020-08-09 |
| 1295360717 | Geni Horne | Nurse Practitioner | 931 Balaye Ridge Cir Apt 301, Tampa, FL 33619-5093 | 2020-03-04 |
| 1669006748 | Andrea Barnett | Nurse Practitioner | 3133 W Villa Rosa St, Tampa, FL 33611-2943 | 2020-02-27 |
| 1679104566 | Chinwe Ifeyinwa Iloanya | Nurse Practitioner | 4603 River Hills Dr, Tampa, FL 33617-6921 | 2020-01-29 |
| 1598231789 | Christee Elan Bond | Nurse Practitioner | 4809 N Armenia Ave Ste 210, Tampa, FL 33603-1425 | 2018-10-16 |
| 1609378991 | Randolph Diabetes and Wellness LLC | Nurse Practitioner | 8017 Savannah Sunset Ln, Tampa, FL 33615-1388 | 2018-03-02 |
| 1912407628 | Jonathan D Pope | Nurse Practitioner | 2708 N 22nd St, Tampa, FL 33605-2760 | 2018-02-19 |
| 1629519814 | Kristen Hanenian | Nurse Practitioner | 4905 W Laurel St, Suite 200, Tampa, FL 33607-3834 | 2017-03-20 |
| 1578006805 | Debbie Kathleen Lovas | Nurse Practitioner | 6016 N Clark Ave, Tampa, FL 33614-5565 | 2016-11-17 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.