Hazel Healthcare LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

HAZEL HEALTHCARE LLC

Practice address

2584 N Stokesberry PL
Meridian, ID 83646-1144

Phone

(208) 412-6905

NPI assigned

Oct 19, 2023

Last updated

Jan 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laura D Carter

Title

Owner, Ceo

Phone

(208) 906-2558

Specialties & licenses 1

Addresses

Tax ID family

Hazel Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Hazel Healthcare LLC

  • Nurse Practitioner
  • Meridian, ID
  • NPI 1962266403
  NPD tax ID

Locations

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1679355036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2584 N STOKESBERRY PL",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836461144",
            "telephone_number": "208-906-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2584 N STOKESBERRY PL",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836461144",
            "telephone_number": "208-412-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZEL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "208-906-2558"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaden Hawes
• Clayton Hawks, NP
• Jason D Haycock, D.C
• Brett E Hayes, MS.PT,
• David Hayes
• Hazel Healthcare LLC
• Jennie Patricia Hazen, L.C.P.C.
• HB Ventures RX LLC (Portico Pharmacy)
• HBS of Meridian, LLC (Cottonwood Creek Behavioral Hospital)
• Dianne Yvonne Head, PMHNP-BC

• Primary Care Nurse Practitioner in Meridian, ID
• Providers in Meridian, ID by specialty
• Primary Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.