Provider Demographics
NPI:1063071736
Name:HAFFORD, PATRICIA P (RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:P
Last Name:HAFFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 E COOPER ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38012-3524
Mailing Address - Country:US
Mailing Address - Phone:239-227-1461
Mailing Address - Fax:
Practice Address - Street 1:904 E COOPER ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38012-3524
Practice Address - Country:US
Practice Address - Phone:239-227-1461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN144761163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse