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General NPI Number Information
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NPI Number | 1801663133
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Entity Type | Individual
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Provider Name | EMMA K HAZEN NP
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Gender | Female
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 110 LOCKWOOD ST FL 6
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City | PROVIDENCE
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State | RI
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Zip | 02903-4801
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Country | US
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Telephone | 401-793-9166
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Fax |
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Provider Business Mailing Address
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Address Line | 192 WEST ST
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City | ATTLEBORO
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State | MA
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Zip | 02703-2637
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Country | US
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Telephone | 508-361-3966
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN59052
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN03913
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License Number State | RI
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