Provider Demographics
NPI:1902599020
Name:HAZELBERG, MARGARET MARY (MSN-NE, RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:HAZELBERG
Suffix:
Gender:F
Credentials:MSN-NE, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 S BUTH RD
Mailing Address - Street 2:
Mailing Address - City:DOUSMAN
Mailing Address - State:WI
Mailing Address - Zip Code:53118-8846
Mailing Address - Country:US
Mailing Address - Phone:262-470-2181
Mailing Address - Fax:
Practice Address - Street 1:536 S BUTH RD
Practice Address - Street 2:
Practice Address - City:DOUSMAN
Practice Address - State:WI
Practice Address - Zip Code:53118-8846
Practice Address - Country:US
Practice Address - Phone:262-470-2181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI222502163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant