JUSTIN MARK HAFNER (NPI# 1366953374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366953374 |
| Entity Type | Individual |
| Full Name | JUSTIN MARK HAFNER |
| Credential | PNP |
| Practice Address |
7501 Quaker Ave Lubbock TX 79424-3367 |
| Mailing Address |
5219 City Bank Pkwy Ste 35 Lubbock TX 79407-3545 |
| Practice Telephone | 8067883306 |
| Practice Fax Number | 8067223861 |
| Mailing Telephone | 8067610333 |
| Mailing Fax Number | 8067820097 |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2019-01-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP135223 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7501 QUAKER AVE |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79424-3367 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748554 | Stephen G Dalton | Family Medicine | 7501 Quaker Ave, Lubbock, TX 79424-3367 | 2005-05-23 |
| 1902416597 | Sarah Ashely Cuneo | Nurse Practitioner | 7501 Quaker Ave, Lubbock, TX 79424-3367 | 2020-08-07 |
| 1831757764 | Jade Rhiannon Goen | Physician Assistant | 7501 Quaker Ave, Lubbock, TX 79424-3367 | 2019-06-05 |
| 1275040776 | Samantha Dawn Gooss | Nurse Practitioner | 7501 Quaker Ave, Lubbock, TX 79424 | 2018-01-05 |
| 1275052631 | Fania Maria Nicolas | Nurse Practitioner | 7501 Quaker Ave, Lubbock, TX 79424-3367 | 2017-09-15 |
| 1851814057 | Andie E Maldonado | Physician Assistant | 7501 Quaker Ave, Lubbock, TX 79424-3367 | 2017-07-19 |
| 1326419748 | Shaun Mantooth | Physician Assistant | 7501 Quaker Ave, Lubbock, TX 79424-3367 | 2015-10-12 |
| 1285062521 | Jennifer Galey | Nurse Practitioner | 7501 Quaker Ave, Lubbock, TX 79424 | 2013-10-24 |
| 1467890822 | Benjamin Matthew Wolcott | Pediatrics | 7501 Quaker Ave, Lubbock, TX 79424-3367 | 2013-06-07 |
| 1386988731 | Hannah Rebong | Nurse Practitioner | 7501 Quaker Ave, Lubbock, TX 79424-3367 | 2012-11-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376158121 | West Texas H.a.n.d. Pllc | Surgery | 5613 114th St, Lubbock, TX 79424 | 2020-09-09 |
| 1811519044 | H-e-b, Lp | Clinical Medical Laboratory | 4405 114th Street, Lubbock, TX 79424 | 2020-05-11 |
| 1184245573 | Jim Lee Lowrance | Chiropractor | 5152 69th Suite 101, Suite 101 Box #2, Lubbock, TX 79424 | 2020-04-27 |
| 1134787377 | April Denise Gardea | Speech-Language Pathologist | 6502 Slide Road Suite 204, Lubbock, TX 79424 | 2019-06-03 |
| 1215590658 | April Dawn Fortner | Counselor | 7617 86th St., Lubbock, TX 79424 | 2019-04-22 |
| 1427514561 | Thornhill Healthcare II, Inc. | Pharmacy | 6823 82nd St, Suite 600, Lubbock, TX 79424 | 2019-02-13 |
| 1174001358 | Emily Cowell | Technician, Other | 6102 82nd St Ste 10, Lubbock, TX 79424 | 2018-07-31 |
| 1043718786 | Edward Murphy | Pharmacist | 8702 Toledo Ave, Lubbock, TX 79424 | 2018-01-29 |
| 1013434364 | Yung Ling Tsai | Specialist/Technologist | 4707 116th Street, Lubbock, TX 79424 | 2017-08-28 |
| 1285187237 | Wter Quaker, Lp | Clinic/Center | 10205 Quaker Ave, Lubbock, TX 79424 | 2016-07-26 |
| Find all providers in zip 79424 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558720045 | Dawn Conwright | Nurse Practitioner | 6809 Slide Rd Ste J, Lubbock, TX 79424-1517 | 2016-02-12 |
| 1538133087 | Wailong Don Lam | Nurse Practitioner | 1318 Broadway St, Lubbock, TX 79401-3206 | 2006-02-13 |
| 1851935365 | Jasmine Sanchez-ximenez | Nurse Practitioner | 4102 24th St Ste 507, Lubbock, TX 79410-1805 | 2019-10-29 |
| 1386108033 | Sara Victoria Chapa | Nurse Practitioner | 416 Frankford Ave, Lubbock, TX 79416-4162 | 2019-01-28 |
| 1902318736 | Olivia A Harris | Nurse Practitioner | 4102 24th St, Lubbock, TX 79410 | 2017-11-02 |
| 1134671159 | Zakri Redding | Nurse Practitioner | 5022 Avenue Q, Lubbock, TX 79412 | 2016-10-25 |
| 1730540097 | Ashley Dometrius | Nurse Practitioner | 4015 22nd Pl, Lubbock, TX 79410-1119 | 2016-03-15 |
| 1336511732 | Meghan Gwyneth Oldham | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415 | 2015-10-24 |
| 1912378118 | Clayton Womack | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2015-10-13 |
| 1699146381 | Raela Stander | Nurse Practitioner | 4102 24th St Ste 504, Lubbock, TX 79410 | 2015-10-07 |
| Find all providers in LUBBOCK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.