Provider Demographics
NPI:1134186612
Name:HATFIELD, GERALINE (APRN,BC)
Entity type:Individual
Prefix:
First Name:GERALINE
Middle Name:
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:APRN,BC
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 1433
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-1433
Mailing Address - Country:US
Mailing Address - Phone:606-835-9333
Mailing Address - Fax:606-835-9997
Practice Address - Street 1:7617 UPPER JOHNS CREEK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PHELPS
Practice Address - State:KY
Practice Address - Zip Code:41553-8775
Practice Address - Country:US
Practice Address - Phone:606-835-9333
Practice Address - Fax:606-835-9997
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3635P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1629114707OtherGROUP NPI NUMBER EKAHC
KY7100146710OtherMEDICAID GROUP PRIMARY CARE NUMBER
KY78007739Medicaid
KY0770101Medicare PIN
KY78007739Medicaid