Individual
SANDRA LUCINDA HAZELWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217
(502) 777-9961
(502) 379-8791
Mailing address
2100 GARDINER LN STE 207, LOUISVILLE, KY 40205-2948
(502) 777-9961
(502) 379-8791
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3007116
KY
363L00000X
Nurse Practitioner
71004745A
IN
363LA2200X
Adult Health Nurse Practitioner
3007116
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201090670
—
IN
05
—
7100194850
—
KY
Enumeration date
09/06/2011
Last updated
05/16/2018
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