Healthcare Provider Details

I. General information

NPI: 1649186131
Provider Name (Legal Business Name): HAIDEN HAURET
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 ROSE STREET
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

103 JAMES LYN DR
HOPKINSVILLE KY
42240-9010
US

V. Phone/Fax

Practice location:
  • Phone: 270-881-6078
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: