Provider Demographics
NPI:1104390111
Name:DUKE FAMILY & WELLNESS
Entity type:Organization
Organization Name:DUKE FAMILY & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HAZELWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:801-695-7587
Mailing Address - Street 1:2909 WASHINGTON BLVD STE 248
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-3744
Mailing Address - Country:US
Mailing Address - Phone:801-603-3246
Mailing Address - Fax:801-797-0235
Practice Address - Street 1:2909 WASHINGTON BLVD STE 248
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-3744
Practice Address - Country:US
Practice Address - Phone:801-603-3246
Practice Address - Fax:801-797-0235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty