Provider Demographics
NPI:1487855011
Name:HAZEN, MELANIE JOYCE (APN)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:JOYCE
Last Name:HAZEN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S RANCHO DR STE D34
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4874
Mailing Address - Country:US
Mailing Address - Phone:702-471-0051
Mailing Address - Fax:702-471-0107
Practice Address - Street 1:601 S RANCHO DR STE D34
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4874
Practice Address - Country:US
Practice Address - Phone:702-471-0051
Practice Address - Fax:702-471-0107
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN00348363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology