MEDICARE: MINDY HAYDEN RN, LAC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	0429	AZ

General Provider Information

NPI Number	:	1528234663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINDY HAYDEN RN, LAC.

Provider Business Mailing Address
First Line	:	2855 E BROWN RD
Second Line	:	STE 17
City	:	MESA
State	:	AZ
Zip	:	85213-4213
Country	:	US
Telephone Number	:	480-641-5353
Fax Number	:	480-641-9320

Provider Business Practice Location Address
First Line	:	2855 E BROWN RD
Second Line	:	STE 17
City	:	MESA
State	:	AZ
Zip	:	85213-4213
Country	:	US
Telephone Number	:	480-641-5353
Fax Number	:	480-641-9320

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	05/07/2008

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