Provider Demographics
NPI:1033778089
Name:NUNN, HAIDEN ALIZABETH (AUD)
Entity type:Individual
Prefix:DR
First Name:HAIDEN
Middle Name:ALIZABETH
Last Name:NUNN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 CADUCEUS WAY
Mailing Address - Street 2:BUILDING 200, SUITE 101
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-7300
Mailing Address - Country:US
Mailing Address - Phone:706-310-7115
Mailing Address - Fax:
Practice Address - Street 1:1360 CADUCEUS WAY STE 101
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-7300
Practice Address - Country:US
Practice Address - Phone:706-310-7115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD004186231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAAUD004186OtherLICENSING BOARD
Q19431AOtherMEDICARE PTAN