Individual provider · Type 1 NPI

Konnor James Hathaway, RN

Registered Nurse · Travis Afb, CA

NPI number 1609749282 Active

Practice location

101 Bodin Cir Bldg 777
Travis Afb, CA 94535-1809

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000XRN95372929 (CA)
Registered Nurse Primary 163W00000X10003980 (OR)

Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…

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About NPI 1609749282

Konnor James Hathaway, RN's National Provider Identifier is 1609749282, issued on Sep 29, 2025. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Travis Afb, CA. The record was last updated on Sep 29, 2025.