Provider Demographics
NPI:1932381142
Name:HATFIELD, JEANINE D (CPNP)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:D
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 CURTISS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BARKSDALE AFB
Mailing Address - State:LA
Mailing Address - Zip Code:71110-2425
Mailing Address - Country:US
Mailing Address - Phone:318-456-6131
Mailing Address - Fax:
Practice Address - Street 1:243 CURTISS RD STE 100243
Practice Address - Street 2:
Practice Address - City:BARKSDALE AFB
Practice Address - State:LA
Practice Address - Zip Code:71110-2425
Practice Address - Country:US
Practice Address - Phone:318-456-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9266402163WP0200X
FLRN9266402363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics