Mary Hazzard, CRNA
Individual provider Active NPI Anesthesiology Physician · Jennersville, PA
NPI 1558415679 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1558415679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- RN180476L (PA)
- Practice address
- 1015 W Baltimore Pike
Jennersville, PA 19390 - Phone
- (610) 869-1000
- Fax
- (610) 869-1246
- NPI assigned
- Jan 23, 2007
- 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)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | RN180476L | PA | Yes |
Addresses
Primary practice location
1015 W Baltimore Pike
Jennersville, PA 19390
Mailing address
213 Reeceville Road
Coatesville, PA 19320-1574
Phone (610) 383-8589
Other providers in Jennersville, PA
All providers in Jennersville, PA · Anesthesiology Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.