# DR. HAZEL G MAHATHA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1104248798
- **Gender:** F
- **Credential:** DNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 10187-33 | WI | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 10187-33 | WI | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 18267 | TN | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 9403701 | FL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AP10720 | AZ | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AP132207 | TX | — |

## Other

- **Enumeration date:** 01/15/2014
- **Last updated:** 08/03/2022