Most Relevant Information
Provider Data
| NPI Number: | 1003230970 |
| Provider Name: | HAZAEL SHAKUR |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | LPO43693 |
Most Important Dates
| Enumeration Date: | 02/12/2014 |
| Last Updated: | 02/12/2014 |
Provider Practice Location
3848 N 3RD AVE UNIT 2019
PHOENIX
AZ
850133461
Practice Location Phone/Fax
| Phone: | 6024353535 |
| Fax: |
Provider Mailing Location
3848 N 3RD AVE UNIT 2019
PHOENIX
AZ
850133461
Provider Mailing Phone/Fax
| Phone: | 6024353535 |
| Fax: |