Provider Demographics
NPI:1467416032
Name:HANSFORD, CECILIA (ARNP)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:HANSFORD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18868
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32523-8868
Mailing Address - Country:US
Mailing Address - Phone:850-994-5660
Mailing Address - Fax:850-994-5841
Practice Address - Street 1:3810 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-1014
Practice Address - Country:US
Practice Address - Phone:850-994-1011
Practice Address - Fax:850-994-0807
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1555482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL59167876OtherBCBS AL
FL304615000Medicaid
FLY1276OtherBCBS FL
FL500026770OtherRAILROAD MEDICARE
FLY1276OtherBCBS FL