Provider Demographics
NPI:1578683173
Name:HAZZARD, RHONDA LYN (RN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:LYN
Last Name:HAZZARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:LYN
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4110 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4650
Mailing Address - Country:US
Mailing Address - Phone:308-635-3171
Mailing Address - Fax:308-635-7026
Practice Address - Street 1:4110 AVENUE D
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4650
Practice Address - Country:US
Practice Address - Phone:308-635-3171
Practice Address - Fax:308-635-7026
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE33673163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health