Hazard, Mindy L

Hazard, Mindy L is an individual health care provider with primary practice located at 2200 Wabash Ave , Springfield IL 62704-5352. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Hazard, Mindy L can be contacted via phone (217) 528-7541.

Contact Information

Primary practice address
2200 Wabash Ave Springfield IL 62704-5352
Phone: (217) 528-7541
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209006014 Illinois

Profile Details

NPI number 1609817543
LBN Legal business name Hazard, Mindy L
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated May 22nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609817543 NPPES
Illinois Other P00350642 RR MEDICARE

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