Lizabeth G Hattaway, APRN FNP-C
Individual provider Active NPI Family Nurse Practitioner · Leesville, LA
NPI 1942223904 · NPPES record last updated Jan 6, 2020
Key facts
- NPI
- 1942223904
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN054182 AP04763 (LA)
- Practice address
- 506 S 6TH St
Leesville, LA 71446-4482 - Phone
- (337) 239-2234
- Fax
- (337) 392-9383
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- CLHG-Leesville
Practice addresses (Care Compare)
427 N Pine St
Byrd Walk in Clinic
Deridder, LA 70634-3905
Phone (337) 462-6471
506 S 6TH St
Byrd Medical Clinic
Leesville, LA 71446-4482
Phone (337) 239-0989
Hospital & facility affiliations
- Allegiance Home Health of Southwest Louisiana, LLC
- Vernon Home Health
- Byrd Regional Hospital
- Beauregard Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050921000063 | LA | Practitioner - Nurse Practitioner | 1951335884 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN054182 AP04763 | LA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CLHG-Leesville | Current |
Accepting new patients | |
| CLHG-Leesville | Current | Accepting new patients | |
| CLHG-Leesville | Current |
Accepting new patients | |
| Byrd Medical Clinic Inc | Past | Accepting new patients | |
| Jackson Parish Hospital | Past | Accepting new patients | |
| Jackson Parish Hospital | Past | Accepting new patients |
Locations
412 S Pine St
Deridder, LA 70634
Phone (337) 462-5700
427 N Pine St
Deridder, LA 70634
Phone (337) 239-0989
1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278
927 Verone Ter
Leesville, LA 71446
Phone (337) 238-1049
506 S 6th St
Leesville, LA 71446
Phone (337) 239-0989
Interoperability endpoints
- lizabeth.hattaway.1@17837.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN054182 AP04763 | LA | Yes |
Addresses
Primary practice location
506 S 6TH St
Leesville, LA 71446-4482
Mailing address
506 S 6TH St
Leesville, LA 71446-4482
Phone (337) 239-2234
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1333603 | Medicaid | LA |
Other providers in Leesville, LA
- Glenda Hancock
- Tanya E Harrell
- Maggie Harrison
- Jim B Harvey
- Sylwia Gabriela Hatley
- Sydney Haymon
- Heal Corporation
- Malorie Hebert
- Shelby Hebing
- Karen L Hendrix
All providers in Leesville, LA · Family Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.