Provider Demographics
NPI:1760690820
Name:HAZE, DEBORAH LYNNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LYNNE
Last Name:HAZE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 SHERIDAN BLVD
Mailing Address - Street 2:ARVADA
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2605
Mailing Address - Country:US
Mailing Address - Phone:303-657-6559
Mailing Address - Fax:
Practice Address - Street 1:7701 SHERIDAN BLVD
Practice Address - Street 2:ARVADA
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2605
Practice Address - Country:US
Practice Address - Phone:303-657-6559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25045164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse