Individual
TERRIE LAVERN HAZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
651 MICA CV, GRANITEVILLE, SC 29829-3282
(803) 426-3087
Mailing address
651 MICA CV, GRANITEVILLE, SC 29829-3282
(803) 426-3087
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN179434
GA
163WG0000X
General Practice Registered Nurse
RN179434
GA
163WR0400X
Rehabilitation Registered Nurse
RN179434
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606317B
—
GA
Enumeration date
12/04/2007
Last updated
05/28/2024
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