Individual
KAILEY J HAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2231 BRYN MAWR AVE, PHILADELPHIA, PA 19131-2508
(215) 883-0800
Mailing address
2001 HAMILTON ST APT 319, PHILADELPHIA, PA 19130-4217
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP021258
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP021258
LICENSE NUMBER
PA
Enumeration date
03/26/2020
Last updated
01/26/2023
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