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General NPI Number Information
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NPI Number | 1013184779
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Entity Type | Individual
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Provider Name | PATRICIA BANASZEK HAZARD CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 1060 W PERIMETER RD
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City | JB ANDREWS
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State | MD
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Zip | 20762-6602
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Country | US
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Telephone | 240-612-1400
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Fax | 240-312-1199
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Provider Business Mailing Address
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Address Line | 1050 W PERIMETER RD
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City | ANDREWS AFB
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State | MD
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Zip | 20762-6601
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Country | US
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Telephone | 240-857-2979
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Fax | 240-857-7170
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | R174850
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License Number State | MD
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