Provider Demographics
NPI:1447234166
Name:THOMPSON, HAZEL LOUISE (ANP-C)
Entity Type:Individual
Prefix:
First Name:HAZEL
Middle Name:LOUISE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:HAZEL
Other - Middle Name:LOUISE
Other - Last Name:THOMPSON-ZIELKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-C
Mailing Address - Street 1:7108 MOUNT HOLLY HUNTERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-8720
Mailing Address - Country:US
Mailing Address - Phone:704-589-2252
Mailing Address - Fax:
Practice Address - Street 1:7108 MOUNT HOLLY HUNTERSVILLE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-8720
Practice Address - Country:US
Practice Address - Phone:704-589-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0050-01109363LP0808X
NC5001109207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1447234166OtherNPI