Basic Information
| Provider Information | |||||||||
| NPI: | 1902234693 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HATFIELD | ||||||||
| FirstName: | ELISE | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 MICCOSUKEE ROAD | ||||||||
| Address2: | BIXLER EMERGENCY CENTER | ||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504310911 | ||||||||
| FaxNumber: | 8504310779 | ||||||||
| Practice Location | |||||||||
| Address1: | 1309 THOMASVILLE ROAD | ||||||||
| Address2: | BIXLER EMERGENCY CENTER | ||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504310911 | ||||||||
| FaxNumber: | 8504310779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2013 | ||||||||
| LastUpdateDate: | 10/16/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA9107483 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.