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General NPI Number Information
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NPI Number | 1982779633
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Entity Type | Individual
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Provider Name | JENNIFER JOHNSON HAZZARD PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 1606 SAVANNAH RD
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City | LEWES
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State | DE
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Zip | 19958-1656
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Country | US
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Telephone | 410-749-4154
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Fax | 410-860-9583
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Provider Business Mailing Address
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Address Line | P.O. BOX 69709
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City | BALTIMORE
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State | MD
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Zip | 21264-9709
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Country | US
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Telephone | 410-860-4506
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Fax | 410-860-8593
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0000566
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License Number State | DE
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