Individual
MICHELLE LEILA HAZLEBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6160 KEMPSVILLE CIR STE 200A, NORFOLK, VA 23502-3945
(757) 622-6315
Mailing address
PO BOX 936, EVMS MEDICAL GROUP, NORFOLK, VA 23501-0936
(757) 446-8960
(757) 446-5197
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004632
VA
Other
Enumeration date
07/10/2014
Last updated
07/21/2022
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