Healthcare Provider Details

I. General information

NPI: 1134186612
Provider Name (Legal Business Name): GERALINE HATFIELD APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 04/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7617 UPPER JOHNS CREEK RD SUITE 100
PHELPS KY
41553-8775
US

IV. Provider business mailing address

PO BOX 1433
PIKEVILLE KY
41502-1433
US

V. Phone/Fax

Practice location:
  • Phone: 606-835-9333
  • Fax: 606-835-9997
Mailing address:
  • Phone: 606-835-9333
  • Fax: 606-835-9997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3635P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: