Healthcare Provider Details

I. General information

NPI: 1528572575
Provider Name (Legal Business Name): EMILEE BETH HAYDEN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 11/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8240 NORTHCREEK DR STE 4100
CINCINNATI OH
45236-0709
US

IV. Provider business mailing address

8240 NORTHCREEK DR STE 4100
CINCINNATI OH
45236-0709
US

V. Phone/Fax

Practice location:
  • Phone: 513-853-7555
  • Fax: 513-853-7550
Mailing address:
  • Phone: 513-853-7555
  • Fax: 513-853-7550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.021414
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.021414
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: