Individual
AMY M HAZLEWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
218 E MAIN ST, FLORENCE, MS 39073-8407
(601) 845-6602
Mailing address
PO BOX 530, FLORENCE, MS 39073-0530
(601) 845-6602
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R874448
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05477720
—
MS
Enumeration date
11/13/2011
Last updated
04/10/2012
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