Provider Demographics
NPI:1730629205
Name:HAYDEN, JUDY III
Entity type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:
Last Name:HAYDEN
Suffix:III
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1795 ALYSHEBA WAY
Mailing Address - Street 2:STE 7204
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2280
Mailing Address - Country:US
Mailing Address - Phone:859-523-4813
Mailing Address - Fax:859-231-0346
Practice Address - Street 1:1795 ALYSHEBA WAY
Practice Address - Street 2:STE 7204
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2280
Practice Address - Country:US
Practice Address - Phone:859-523-4813
Practice Address - Fax:859-231-0346
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty