Provider Demographics
NPI:1891382925
Name:HIZON, JOEL D (RN)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:D
Last Name:HIZON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3461 SPOTTED SANDPIPER ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-3537
Mailing Address - Country:US
Mailing Address - Phone:720-717-2679
Mailing Address - Fax:
Practice Address - Street 1:2935 S HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-3715
Practice Address - Country:US
Practice Address - Phone:702-207-2367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV834784163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV834784OtherNEVADA BOARD OF NURSING LICENSE