Individual
REBECCA HAYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
11125 DUNN ROAD SUITE 213, PHYSICIANS OFFICE BUILDING 2, ST. LOUIS, MO 63136-6132
(314) 479-7749
(314) 469-2992
Mailing address
PO BOX 410664, ST. LOUIS, MO 63141-0664
(314) 749-7749
(314) 469-2992
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN140351
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424877215
—
MO
01
—
P00141675
RAILROAD MEDICARE
MO
Enumeration date
07/19/2005
Last updated
11/03/2011
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