Individual
DEDRA HAYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
422 HEYWOOD AVE, LOUISVILLE, KY 40208-1346
(502) 636-3133
(502) 636-1155
Mailing address
422 HEYWOOD AVE, LOUISVILLE, KY 40208-1346
(502) 636-3133
(502) 636-1155
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3006183
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3006183
ARNP-REGISTRATION
KY
01
—
6183P
ARNP REGISTRATION
KY
Enumeration date
10/05/2009
Last updated
06/01/2012
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