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NPI Code Detail

MEDICARE: KELVIN HAZANGWI

MEDICARE: KELVIN HAZANGWI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6439ND
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1013620624
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELVIN HAZANGWI
Provider Business Mailing Address
First Line : 316 2ND AVE W
Second Line :
City : WILLISTON
State : ND
Zip : 58801-5218
Country : US
Telephone Number : 701-774-4600
Fax Number :
Provider Business Practice Location Address
First Line : 316 2ND AVE W
Second Line :
City : WILLISTON
State : ND
Zip : 58801-5218
Country : US
Telephone Number : 701-774-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2022
Last Update Date : 03/19/2026

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Directions to “ KELVIN HAZANGWI ” Practice Location

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