Active NPI
Therese Marie Hazen, RN, IBCLC
- Lactation Consultant (Registered Nurse)
- Willoughby, OH
National Provider Identifier
1114134970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Registered Nurse)
- License
- RN 222531
- Practice address
- 4799 Maple St
Willoughby, OH 44094-5732 - Phone
- (440) 479-2780
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Registered Nurse) | 163WL0100X | RN 222531 | OH | Primary |
Addresses
Primary practice location
4799 Maple St
Willoughby, OH 44094-5732
Mailing address
4799 Maple St
Willoughby, OH 44094-5732
Phone (440) 479-2780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN 222531 | OH | MD | Lactation Consultant (Registered Nurse) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308700800000",
"number": "1114134970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4799 MAPLE ST",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440945732",
"telephone_number": "440-479-2780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4799 MAPLE ST",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440945732",
"telephone_number": "440-479-2780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZEN",
"first_name": "THERESE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "RN, IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2011-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "163WL0100X",
"taxonomy_group": "",
"desc": "Registered Nurse, Lactation Consultant",
"state": "OH",
"license": "RN 222531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willoughby, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.