Provider Demographics
NPI:1437450574
Name:HAFER, ALBERT M (RN)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:M
Last Name:HAFER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5133 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-9499
Mailing Address - Country:US
Mailing Address - Phone:740-965-9423
Mailing Address - Fax:
Practice Address - Street 1:5133 HARLEM RD
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:OH
Practice Address - Zip Code:43021-9499
Practice Address - Country:US
Practice Address - Phone:740-965-9423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.343608163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health