Hazel Darlene Hathorn, LVN

Individual provider Active NPI Licensed Vocational Nurse · Bishop, TX

NPI 1194206458 · NPPES record last updated Aug 24, 2018

Key facts

NPI
1194206458
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Vocational Nurse 164X00000X
License
151871 (TX)
Practice address
512 Meadowbrook Rd
Bishop, TX 78343-3103
Phone
(361) 226-6198
NPI assigned
Aug 24, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
151871TXMDLicensed Vocational Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 151871 TX Yes

Addresses

Primary practice location

512 Meadowbrook Rd
Bishop, TX 78343-3103

Mailing address

PO Box 651
Aransas Pass, TX 78335-0651
Phone (361) 226-6198

Other providers in Bishop, TX

All providers in Bishop, TX · Licensed Vocational Nurse in Texas

Sources for this page

Verify at the official NPI Registry.