Healthcare Provider Details

I. General information

NPI: 1457263121
Provider Name (Legal Business Name): SABRINA DAIE HAZEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16601 N 40TH ST STE 104
PHOENIX AZ
85032-3353
US

IV. Provider business mailing address

16601 N 40TH ST STE 104
PHOENIX AZ
85032-3353
US

V. Phone/Fax

Practice location:
  • Phone: 602-633-3721
  • Fax: 602-953-5466
Mailing address:
  • Phone: 602-633-3721
  • Fax: 602-953-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number253349
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: