Provider Demographics
NPI:1902234693
Name:HATFIELD, ELISE (PA)
Entity Type:Individual
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First Name:ELISE
Middle Name:
Last Name:HATFIELD
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1300 MICCOSUKEE ROAD
Mailing Address - Street 2:BIXLER EMERGENCY CENTER
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308
Mailing Address - Country:US
Mailing Address - Phone:850-431-0911
Mailing Address - Fax:850-431-0779
Practice Address - Street 1:1309 THOMASVILLE ROAD
Practice Address - Street 2:BIXLER EMERGENCY CENTER
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303
Practice Address - Country:US
Practice Address - Phone:850-431-0911
Practice Address - Fax:850-431-0779
Is Sole Proprietor?:No
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
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Provider Licenses
StateLicense IDTaxonomies
FLPA9107483363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant