MEDICARE: EMILEE BETH HAYDEN CNP

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	363LG0600X	Gerontology Nurse Practitioner	APRN.CNP.021414	OH
2	363LA2200X	Adult Health Nurse Practitioner	APRN.CNP.021414	OH

General Provider Information

NPI Number	:	1528572575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILEE BETH HAYDEN CNP

Provider Business Mailing Address
First Line	:	8240 NORTHCREEK DR STE 4100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-0709
Country	:	US
Telephone Number	:	513-853-7555
Fax Number	:	513-853-7550

Provider Business Practice Location Address
First Line	:	8240 NORTHCREEK DR STE 4100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45236-0709
Country	:	US
Telephone Number	:	513-853-7555
Fax Number	:	513-853-7550

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

Provider Enumeration Date	:	11/29/2017
Last Update Date	:	11/29/2017

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