Provider Demographics
NPI:1265041651
Name:HADFIELD, ANNIE MALI (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:MALI
Last Name:HADFIELD
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 STONEY PT
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1001
Mailing Address - Country:US
Mailing Address - Phone:949-338-3566
Mailing Address - Fax:
Practice Address - Street 1:28 STONEY PT
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1001
Practice Address - Country:US
Practice Address - Phone:949-338-3566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014972363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care