Individual
GRADAPHENE I HAYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
12 SUNSHINE LN, SCOTTSVILLE, KY 42164-7962
(904) 598-4622
Mailing address
12 SUNSHINE LN, SCOTTSVILLE, KY 42164-7962
(904) 598-4622
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3017577
KY
363LF0000X
Family Nurse Practitioner
Primary
3017577
KY
Other
Enumeration date
03/23/2022
Last updated
11/15/2024
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