Healthcare Provider Details

I. General information

NPI: 1699347625
Provider Name (Legal Business Name): BRITTANY LYNN HAYDEN CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 07/09/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 BEAUBIEN ST
DETROIT MI
48201-2119
US

IV. Provider business mailing address

1836 ALINE DR
GROSSE POINTE WOODS MI
48236-1004
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-5437
  • Fax:
Mailing address:
  • Phone: 734-756-8408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number4704318428
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: