Healthcare Provider Details

I. General information

NPI: 1356388722
Provider Name (Legal Business Name): DEBBRA L HADDEN ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COLLEGE PARKWAY SUITE 220
WILLIAMSVILLE NY
14221-6800
US

IV. Provider business mailing address

100 COLLEGE PARKWAY SUITE 220
WILLIAMSVILLE NY
14221
US

V. Phone/Fax

Practice location:
  • Phone: 716-626-9900
  • Fax: 716-626-9100
Mailing address:
  • Phone: 716-626-9900
  • Fax: 716-626-9100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF303937-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: