| Doctor Name: | MRS. GEORGIA GLENN HAZZARD |
| NPI Number: | 1255799649 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | 17306 |
| Business Practice Address: | 300 11271 State Route 762 Orient, OH - 43146 |
| Business Phone Number: | 6148772441 |
| Business Fax Number: | 6148773853 |
| Mailing Address: | Po Box 300, 11271 State Route 762 ORIENT |
| State: | OH |
| Postal Code: | 431460300 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/01/2016 |
| NPI Last Update Date: | 02/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 17306 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |