Individual
MRS. GINA OETGEN HAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
4 E JACKSON BLVD, SAVANNAH, GA 31405-5810
(912) 355-1010
Mailing address
4750 WATERS AVE STE 202, SAVANNAH, GA 31404-6278
(912) 350-7412
(912) 350-7297
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN152773
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01721151
AMERIGROUP
—
05
—
615817424C
—
GA
05
—
615817424D
—
GA
01
—
761061
WELLCARE
GA
05
—
NP2156
—
SC
01
—
P01110452
RAILROAD MEDICARE
GA
01
—
P01278462
RAILROAD MEDICARE
GA
Enumeration date
12/22/2009
Last updated
07/10/2024
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