Provider Demographics
NPI:1922068667
Name:RAIFORD, HESTER ELIZABETH (ARNP)
Entity Type:Individual
Prefix:MS
First Name:HESTER
Middle Name:ELIZABETH
Last Name:RAIFORD
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:UFJP PROVIDER ENROLLMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:904-244-3660
Mailing Address - Fax:904-244-3425
Practice Address - Street 1:11481 OLD SAINT AUGUSTINE RD
Practice Address - Street 2:UFJP AUGUSTINE OAKS FAMILY PRACTICE CTR
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-1402
Practice Address - Country:US
Practice Address - Phone:904-260-1818
Practice Address - Fax:904-260-4182
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2007-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP389062363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00041785Medicare PIN
FLE2219YMedicare PIN
FLS75251Medicare UPIN