Provider Demographics
NPI:1376690065
Name:HADFIELD, JEANNETTE BURKE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:JEANNETTE
Middle Name:BURKE
Last Name:HADFIELD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5137 MEADOWSTREAM GARTH
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21161-9506
Mailing Address - Country:US
Mailing Address - Phone:410-557-6288
Mailing Address - Fax:
Practice Address - Street 1:1021 DULANEY VALLEY RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2753
Practice Address - Country:US
Practice Address - Phone:410-337-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR058346363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care