Provider Demographics
NPI:1407498256
Name:HAZEL, SILVIA VALENCIA (CRNP)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:VALENCIA
Last Name:HAZEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17748 CHIPPING CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1625
Mailing Address - Country:US
Mailing Address - Phone:301-502-2136
Mailing Address - Fax:
Practice Address - Street 1:10005 OLD COLUMBIA RD STE P170
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1727
Practice Address - Country:US
Practice Address - Phone:410-312-5280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR210282363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily