Provider Demographics
NPI:1770451106
Name:HATFIELD, TERRY
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:HATFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13812 ORCHARD CT APT 102
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-5924
Mailing Address - Country:US
Mailing Address - Phone:813-679-1850
Mailing Address - Fax:
Practice Address - Street 1:13812 ORCHARD CT APT 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-5924
Practice Address - Country:US
Practice Address - Phone:813-679-1850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FL372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care Coordinator