Provider Demographics
NPI:1548887698
Name:NELSON, HATTIE HOSKINS (NP)
Entity type:Individual
Prefix:
First Name:HATTIE
Middle Name:HOSKINS
Last Name:NELSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 SAMUELS AVE APT 4019
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-1452
Mailing Address - Country:US
Mailing Address - Phone:662-379-7131
Mailing Address - Fax:
Practice Address - Street 1:637 SAMUELS AVE APT 4019
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-1452
Practice Address - Country:US
Practice Address - Phone:662-379-7131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-05
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014923363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty