Individual provider Active NPI

Brianna Lynn Hazelwood, RN

  • Registered Nurse
  • Mineola, TX
National Provider Identifier
1154889574
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
960002 Issued in TX
Practice address
1360 County Road 2336
Mineola, TX 75773-3324
Phone
(903) 571-4469
NPI assigned
Mar 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 960002 TX Primary

Addresses

Primary practice location

1360 County Road 2336
Mineola, TX 75773-3324

Mailing address

1360 County Road 2336
Mineola, TX 75773-3324
Phone (903) 571-4469

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

LicenseStateTypeSpecialty
960002TXMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1154889574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 COUNTY ROAD 2336",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757733324",
            "telephone_number": "903-571-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 COUNTY ROAD 2336",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757733324",
            "telephone_number": "903-571-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELWOOD",
        "first_name": "BRIANNA",
        "middle_name": "LYNN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "960002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.