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General NPI Number Information
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NPI Number | 1356670350
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Entity Type | Individual
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Provider Name | GINA OETGEN HAZEL FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/22/2009
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 4 E JACKSON BLVD
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City | SAVANNAH
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State | GA
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Zip | 31405-5810
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Country | US
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Telephone | 912-355-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 4750 WATERS AVE STE 202
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City | SAVANNAH
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State | GA
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Zip | 31404-6278
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Country | US
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Telephone | 912-350-7412
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Fax | 912-350-7297
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN152773
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License Number State | GA
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