Provider Demographics
NPI:1265436224
Name:HATFIELD, CHERRI DENISE (PA-C)
Entity type:Individual
Prefix:MS
First Name:CHERRI
Middle Name:DENISE
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 E 2ND AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661-3602
Mailing Address - Country:US
Mailing Address - Phone:304-664-8924
Mailing Address - Fax:304-664-8746
Practice Address - Street 1:RT 52 MAIN ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:WV
Practice Address - Zip Code:25621-1675
Practice Address - Country:US
Practice Address - Phone:304-664-8924
Practice Address - Fax:304-664-8746
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV962363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0051870000Medicaid
WV2025113Medicare PIN
WV2025112Medicare PIN
WV0051870000Medicaid
WV2025114Medicare PIN
WVP69388Medicare UPIN
WV2025115Medicare PIN
WV2025116Medicare PIN