Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miss. Kelly Nicole Hafers, PA-C

Individual provider Physician Assistant · NPI 1104408061

Miss. Kelly Nicole Hafers, PA-C is a Physician Assistant in Bridgeport, Connecticut. Practices as a sole proprietor and works from 2 locations. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

30 Hazel St
Bridgeport, CT 06604-7752
Phone: (203) 576-4880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 48 Burma Rd, Wyckoff, NJ 07481-3302 — (201) 414-7303

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1104408061
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedApril 21, 2021
Last updated in NPPESJuly 13, 2021
Certification dateJuly 13, 2021

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