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General NPI Number Information
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NPI Number | 1194441113
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Entity Type | Individual
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Provider Name | HANNAH OLIVIA JAZDZEWSKI MSN, AGPCNP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2022
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 4001 KRESGE WAY STE 236
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City | LOUISVILLE
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State | KY
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Zip | 40207-4640
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Country | US
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Telephone | 502-893-7372
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Fax | 502-409-4715
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Provider Business Mailing Address
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Address Line | 126 HALDEMAN AVE
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City | LOUISVILLE
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State | KY
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Zip | 40206-2031
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Country | US
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Telephone | 859-704-0440
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 3018504
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 3018504
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License Number State | KY
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