Provider Demographics
NPI:1679383004
Name:PLACIDES, HAZEL ANNE (PMHNP)
Entity type:Individual
Prefix:
First Name:HAZEL ANNE
Middle Name:
Last Name:PLACIDES
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:HAZEL ANNE
Other - Middle Name:M
Other - Last Name:DUERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:335 ANNA CAROL DR
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-2758
Mailing Address - Country:US
Mailing Address - Phone:443-988-2794
Mailing Address - Fax:
Practice Address - Street 1:101 DRUMMER DR
Practice Address - Street 2:
Practice Address - City:GRASONVILLE
Practice Address - State:MD
Practice Address - Zip Code:21638-1202
Practice Address - Country:US
Practice Address - Phone:410-413-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR258380363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health