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General NPI Number Information
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NPI Number | 1083228092
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Entity Type | Individual
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Provider Name | KRISTIN DENEILLE HAZEMAN DNP, APRN, CNM
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Gender | Female
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Dates
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Enumeration Date | 09/07/2020
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 1001 HART BLVD STE 100
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City | MONTICELLO
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State | MN
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Zip | 55362-8929
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Country | US
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Telephone | 763-295-2921
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Fax | 763-581-9090
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Provider Business Mailing Address
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Address Line | 19170 JASPER ST NW
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City | ANOKA
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State | MN
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Zip | 55303-9639
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Country | US
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Telephone | 612-867-7331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WX0002X
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Taxonomy Name | High-Risk Obstetric Registered Nurse
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License Number | 204419-0
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 591
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License Number State | MN
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