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NPI Code Detail

MEDICARE: CARLY MARANNE HAZZARD ANDREWS NP

MEDICARE: CARLY MARANNE HAZZARD ANDREWS NP
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
1363L00000XNurse Practitioner902784MS

General Provider Information

NPI Number : 1194211094
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLY MARANNE HAZZARD ANDREWS NP
Provider Business Mailing Address
First Line : 800 N PEARMAN AVE
Second Line :
City : CLEVELAND
State : MS
Zip : 38732-3502
Country : US
Telephone Number : 888-757-0838
Fax Number : 662-579-3378
Provider Business Practice Location Address
First Line : 800 N PEARMAN AVE
Second Line :
City : CLEVELAND
State : MS
Zip : 38732-3502
Country : US
Telephone Number : 888-757-0838
Fax Number : 662-579-3378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2018
Last Update Date : 08/10/2023

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