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General NPI Number Information
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NPI Number | 1912440850
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Entity Type | Individual
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Provider Name | KASIE HAZEN ARNP
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Gender | Female
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Dates
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Enumeration Date | 11/27/2016
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 19021 N DALE MABRY HWY
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City | LUTZ
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State | FL
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Zip | 33548-4982
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Country | US
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Telephone | 813-961-5201
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Fax | 813-377-1685
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Provider Business Mailing Address
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Address Line | 2191 9TH AVE N STE 110
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City | ST PETERSBURG
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State | FL
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Zip | 33713-7147
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Country | US
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Telephone | 727-820-7778
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Fax | 727-820-7779
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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 | ARNP 9350294
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License Number State | FL
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