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General NPI Number Information
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NPI Number | 1194109777
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Entity Type | Individual
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Provider Name | TONYA R SHEPHERD HATFIELD APRN
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Gender | Female
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 338 KY ROUTE 550
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City | EASTERN
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State | KY
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Zip | 41622-0193
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Country | US
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Telephone | 606-949-1220
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 193
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City | EASTERN
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State | KY
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Zip | 41622-0193
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Country | US
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Telephone | 606-226-8677
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3009497
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License Number State | KY
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