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NPI Code Detail

MEDICARE: CHRISTI DAWN WALES HAZLETT

MEDICARE:   CHRISTI DAWN WALES HAZLETT
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1144266719
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTI DAWN WALES HAZLETT
Provider Business Mailing Address
First Line : 2400 S 48TH ST
Second Line :
City : SPRINGDALE
State : AR
Zip : 72762-6683
Country : US
Telephone Number : 479-750-2020
Fax Number : 479-750-4843
Provider Business Practice Location Address
First Line : 827 W HARVARD ST
Second Line :
City : SILOAM SPRINGS
State : AR
Zip : 72761-4013
Country : US
Telephone Number : 479-549-3121
Fax Number : 479-750-4843
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2006
Last Update Date : 03/22/2019

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Directions to “ CHRISTI DAWN WALES HAZLETT ” Practice Location

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