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General NPI Number Information
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NPI Number | 1588893978
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Entity Type | Individual
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Provider Name | OZZIE AMENDA HAIRSTON DNP, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 4111 ROSE LAKE DR STE 8922
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City | CHARLOTTE
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State | NC
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Zip | 28217-2829
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Country | US
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Telephone | 281-406-1112
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Fax | 713-583-2081
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Provider Business Mailing Address
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Address Line | 4526 FEDERAL AVE
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City | EVERETT
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State | WA
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Zip | 98203-2132
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Country | US
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Telephone | 425-349-6200
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Fax | 713-583-1431
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61379476
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1012284
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN61379474
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License Number State | WA
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