Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | ARNP9350181 | FL |
NPI | 1013453570 |
---|---|
Provider Name | Holly Hazelett |
First Address | Fort Lauderdale, FL 33308-4603 |
Second Address | Fort Lauderdale, FL 33308-4603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2017 |
Last Update Date | 21/02/2017 |