| Nicole R Hazelwood, CRNA | |
|
216 Elm St, Jackson, MO 63755-1708 | |
| (573) 576-1903 | |
| Not Available |
| Full Name | Nicole R Hazelwood |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 16 Years |
| Location | 216 Elm St, Jackson, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558504076 | NPI | - | NPPES |
| 110375 | Other | MO | HEALTHLINK |
| P00726014 | Other | MO | RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 041429789 (Illinois) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 2002019453 (Missouri) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Asc Anesthesia Llc | 4789099896 | 3 |
| Entity Name | Mid-america Anesthesia Consultants, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083728463 PECOS PAC ID: 6305837626 Enrollment ID: O20040524000952 |
| Entity Name | Iron County Hospital District |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1477648178 PECOS PAC ID: 0941207526 Enrollment ID: O20061104000718 |
| Entity Name | Pemiscot County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578668661 PECOS PAC ID: 8426024159 Enrollment ID: O20070326000204 |
| Entity Name | Auburn Surgery Center Inc. |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1265431670 PECOS PAC ID: 2961567854 Enrollment ID: O20090209000625 |
| Entity Name | Acuity Anesthesiology Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134353030 PECOS PAC ID: 6305992652 Enrollment ID: O20090929000038 |
| Entity Name | Guardian Anesthesia Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215366307 PECOS PAC ID: 6608005111 Enrollment ID: O20140203001776 |
| Entity Name | Aim Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245685601 PECOS PAC ID: 3971896705 Enrollment ID: O20160801001265 |
| Entity Name | Asc Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740873033 PECOS PAC ID: 4789099896 Enrollment ID: O20210224000314 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole R Hazelwood, CRNA 216 Elm St, Jackson, MO 63755-1708 Ph: (573) 576-1903 | Nicole R Hazelwood, CRNA 216 Elm St, Jackson, MO 63755-1708 Ph: (573) 576-1903 |