Georgia Glenn Hazzard, CNP

Individual provider Active NPI Adult Health Nurse Practitioner · Orient, OH

NPI 1255799649 · NPPES record last updated Feb 1, 2016

Key facts

NPI
1255799649
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
17306 (OH)
Practice address
300 11271 State Route 762
Orient, OH 43146
Phone
(614) 877-2441
Fax
(614) 877-3853
NPI assigned
Feb 1, 2016
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
17306OHMDAdult Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 17306 OH Yes

Addresses

Primary practice location

300 11271 State Route 762
Orient, OH 43146

Mailing address

PO Box 300
11271 State Route 762
Orient, OH 43146-0300

Other providers in Orient, OH

All providers in Orient, OH · Adult Health Nurse Practitioner in Ohio

Sources for this page

Verify at the official NPI Registry.