Individual
BROOKLYN HAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
815 W BROAD ST STE 220, COLUMBUS, OH 43222-1478
(614) 799-0822
(614) 717-4427
Mailing address
815 W BROAD ST STE 220, COLUMBUS, OH 43222-1478
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
444272
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
444272
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
444272
NURSING LICENSE
OH
Enumeration date
07/24/2020
Last updated
08/24/2024
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