Provider Demographics
NPI:1013184779
Name:HAZARD, PATRICIA BANASZEK (CRNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:BANASZEK
Last Name:HAZARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:BANASZEK
Other - Last Name:HAZARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1050 W PERIMETER RD
Mailing Address - Street 2:
Mailing Address - City:ANDREWS AFB
Mailing Address - State:MD
Mailing Address - Zip Code:20762-6601
Mailing Address - Country:US
Mailing Address - Phone:240-857-2979
Mailing Address - Fax:240-857-7170
Practice Address - Street 1:1060 W PERIMETER RD
Practice Address - Street 2:
Practice Address - City:JB ANDREWS
Practice Address - State:MD
Practice Address - Zip Code:20762-6602
Practice Address - Country:US
Practice Address - Phone:240-612-1400
Practice Address - Fax:240-312-1199
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR174850363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology