Provider Demographics
NPI:1518448026
Name:MCCRAW, HAZEL NELL (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:HAZEL
Middle Name:NELL
Last Name:MCCRAW
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 SPRING VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75964-5773
Mailing Address - Country:US
Mailing Address - Phone:832-453-3674
Mailing Address - Fax:
Practice Address - Street 1:625 WOODWAY LN
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-2517
Practice Address - Country:US
Practice Address - Phone:936-462-3117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX256761163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics