Individual
KAITLYN HAZELMYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
736 IRVING AVE, SYRACUSE, NY 13210-1687
(315) 470-7111
Mailing address
736 IRVING AVE, NURSE PRACTITIONER DEPARTMENT, SYRACUSE, NY 13210-1687
(315) 415-5849
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
346101
NY
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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