Provider Demographics
NPI:1972211712
Name:MAEZER, LLC
Entity Type:Organization
Organization Name:MAEZER, LLC
Other - Org Name:BUSY MOMS HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEAL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNM, IBCLC
Authorized Official - Phone:304-212-5663
Mailing Address - Street 1:10000 COOMBS FARM RD STE 106
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-1157
Mailing Address - Country:US
Mailing Address - Phone:304-212-5663
Mailing Address - Fax:304-936-0101
Practice Address - Street 1:10000 COOMBS FARM RD STE 106
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-1157
Practice Address - Country:US
Practice Address - Phone:304-212-5663
Practice Address - Fax:304-936-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty