Healthcare Provider Details

I. General information

NPI: 1356700777
Provider Name (Legal Business Name): JULIANA HADDEN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3019 NE MORENO PL
BEND OR
97701-3996
US

IV. Provider business mailing address

3019 NE MORENO PL
BEND OR
97701-3996
US

V. Phone/Fax

Practice location:
  • Phone: 541-601-3705
  • Fax:
Mailing address:
  • Phone: 541-601-3705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10063883
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: