Provider Demographics
NPI:1154724821
Name:HAZELL, ELIZABETH (CBE)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HAZELL
Suffix:
Gender:F
Credentials:CBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 S APACHE ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-2979
Mailing Address - Country:US
Mailing Address - Phone:913-645-9473
Mailing Address - Fax:
Practice Address - Street 1:2021 S APACHE ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-2979
Practice Address - Country:US
Practice Address - Phone:913-645-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor