Healthcare Provider Details

I. General information

NPI: 1669516589
Provider Name (Legal Business Name): KAREN A HAYDEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 11/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 DUDLEY ST. SUITE 360
PROVIDENCE RI
02905
US

IV. Provider business mailing address

2 DUDLEY ST. SUITE 360
PROVIDENCE RI
02905
US

V. Phone/Fax

Practice location:
  • Phone: 401-453-4500
  • Fax: 401-444-2801
Mailing address:
  • Phone: 401-453-4500
  • Fax: 401-444-2801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNPP37177
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: