Provider Demographics
NPI:1942715909
Name:HAZELWOOD, DAWNA NICHOLE (APRN AGACNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:DAWNA
Middle Name:NICHOLE
Last Name:HAZELWOOD
Suffix:
Gender:F
Credentials:APRN AGACNP-BC
Other - Prefix:
Other - First Name:DAWNA
Other - Middle Name:NICHOLE
Other - Last Name:NEFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AG-ACNP
Mailing Address - Street 1:13818 OLD DOCK RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-9508
Mailing Address - Country:US
Mailing Address - Phone:912-272-4791
Mailing Address - Fax:
Practice Address - Street 1:720 W OAK ST STE 360
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4910
Practice Address - Country:US
Practice Address - Phone:407-846-0090
Practice Address - Fax:407-846-0072
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN202623163WC0200X, 363LA2100X
FLAPRN9494274363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine