Jeremy W Hazeltine

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

132938 IV Issued in OH

Practice address

511 Harrison St
Piqua, OH 45356-2427

Phone

(937) 778-1132

NPI assigned

Dec 8, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Jeremy W Hazeltine Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1265677074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 HARRISON ST",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453562427",
            "telephone_number": "937-778-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 HARRISON ST",
            "city": "PIQUA",
            "state": "OH",
            "postal_code": "453562427",
            "telephone_number": "937-778-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELTINE",
        "first_name": "JEREMY",
        "middle_name": "W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "132938            IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEREMY",
            "last_name": "HAZELTINE",
            "middle_name": "W",
            "prefix": "MR.",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Harbor Nursing Inc
• Jade Harner
• Michelle Marie Harrison, LPN
• Jessica Boldt Hartson
• Nicole Lynne Hatcher
• Kristi Lynn Hazeltine, RN
• HCF of Garbry Ridge, Inc.
• HCF of Piqua, Inc.
• HCF of Piqua, Inc.
• Heartland of Piqua Oh LLC

• Licensed Practical Nurse in Piqua, OH
• Providers in Piqua, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; 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.