Individual
TANEA RENEE HAZZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 GREEN RIVER CT, INDIANAPOLIS, IN 46229-9500
(317) 533-0598
Mailing address
1212 GREEN RIVER CT, INDIANAPOLIS, IN 46229-9500
(317) 533-0598
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300119443
—
IN
Enumeration date
04/25/2025
Last updated
12/19/2025
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