Healthcare Provider Details

I. General information

NPI: 1942213608
Provider Name (Legal Business Name): MARTHA LOWE HADDEN MS. RN. CS.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 HANFT KNLS
CHAPEL HILL NC
27514-3257
US

IV. Provider business mailing address

112 HANFT KNLS
CHAPEL HILL NC
27514-3257
US

V. Phone/Fax

Practice location:
  • Phone: 919-968-8787
  • Fax:
Mailing address:
  • Phone: 919-968-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN 107909
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: