Hazel, Ellen Marie

Hazel, Ellen Marie is an individual health care provider with primary practice located at 1055 37Th Pl , Vero Beach FL 32960-6551. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Hazel, Ellen Marie can be contacted via phone (772) 257-8700.

Contact Information

Primary practice address
1055 37Th Pl Vero Beach FL 32960-6551
Phone: (772) 257-8700
Fax: (772) 257-8715
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 144650 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP 9363178 Florida

Profile Details

NPI number 1619164480
LBN Legal business name Hazel, Ellen Marie
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2007
Last updated Apr 11th, 2017 - about 7 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 1619164480 NPPES
North Carolina MEDICAID 8050945

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