Active NPI
Erin Hazen
- Pharmacist
- Willmar, MN
National Provider Identifier
1659747038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 119894
- Practice address
- 101 Willmar Ave SW
Willmar, MN 56201-3556 - Phone
- (320) 214-6975
- Fax
- (320) 214-6978
- NPI assigned
- Aug 19, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 119894 | MN | Primary |
| Pharmacist | 183500000X | 6696 | MT |
Addresses
Primary practice location
101 Willmar Ave SW
Willmar, MN 56201-3556
Mailing address
22830 15TH St SW
Blomkest, MN 56216-9767
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119894 | MN | MD | Pharmacist |
| 6696 | MT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439942400000",
"number": "1659747038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22830 15TH ST SW",
"city": "BLOMKEST",
"state": "MN",
"postal_code": "562169767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WILLMAR AVE SW",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562013556",
"telephone_number": "320-214-6975",
"fax_number": "320-214-6978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZEN",
"first_name": "ERIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-19",
"last_updated": "2015-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "119894",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "6696",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willmar, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.