Jeremy Scott Hataway, FNP-BC is a family nurse practitioner in Grand Prairie, TX. Jeremy Scott Hataway, FNP-BC NPI is 1528203155. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
4560 LAKE RIDGE PKWY STE 110
GRAND PRAIRIE, TX
ZIP 75052-707
Phone: (972) 522-7778
Fax: (972) 522-7779
The NPI 1528203155 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 12/11/2008 and was last updated on 10/6/2021.