Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

MS. Michelle Dawn Hazen, APRN-CNP

Individual provider Family Nurse Practitioner · NPI 1902414527

MS. Michelle Dawn Hazen, APRN-CNP is a Nurse Practitioner in Moscow, Idaho. Qualified in 2020, 6 years ago. Practices with Gritman Medical Center Inc, a 27-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
6
Licensed in
ID
In the registry since
2020

Practice location Address checks out

831 S Ash St
Moscow, ID 83843
Phone: (208) 885-6693
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 700 S Main St, Moscow, ID 83843-3046 — (288) 882-4511
  • 623 S Main St Ste 1, Moscow, ID 83843-3042 — (208) 882-2011
  • 5217 Robinson Park Rd, Moscow, ID 83843-9194 — (208) 761-2408

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 65286 (ID)

Record details

NPI number1902414527
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-CNP
Sole proprietorNo
NPI enumeratedJuly 20, 2020
Last updated in NPPESSeptember 12, 2025
Certification dateSeptember 12, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Gritman Medical Center Inc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Moscow