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General NPI Number Information
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NPI Number | 1366072167
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Entity Type | Organization
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Legal Business Name | HAZEN'S MENTAL HEALTH
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Dates
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Enumeration Date | 01/21/2020
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 1400 N SILVER ST
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City | T OR C
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State | NM
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Zip | 87901-1957
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Country | US
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Telephone | 575-894-7855
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 388
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City | ELEPHANT BUTTE
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State | NM
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Zip | 87935-0388
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Country | US
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Telephone | 575-497-9037
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH NURSE PRACTITIONER
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Name | MRS. RHEA ANN HAZEN
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Credential | NP
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Telephone | 575-497-9037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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