Healthcare Provider Details

I. General information

NPI: 1215463013
Provider Name (Legal Business Name): HAZEL ARRIOLA ROSALES FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 FIRST COLONIAL RD
VIRGINIA BEACH VA
23454
US

IV. Provider business mailing address

1060 FIRST COLONIAL RD
VIRGINIA BEACH VA
23454-3002
US

V. Phone/Fax

Practice location:
  • Phone: 757-395-2323
  • Fax:
Mailing address:
  • Phone: 757-395-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024174769
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: