Provider Demographics
NPI:1336818319
Name:HADDEN, STEPHEN THOMAS (FNP-C)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:THOMAS
Last Name:HADDEN
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:TOMMY
Other - Middle Name:
Other - Last Name:HADDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1605 LILLIANS POINT CT
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-7809
Mailing Address - Country:US
Mailing Address - Phone:502-794-3774
Mailing Address - Fax:
Practice Address - Street 1:6330 QUADRANGLE DR STE 500
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8281
Practice Address - Country:US
Practice Address - Phone:502-794-3774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-13
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017791363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5017791OtherAPRN
NC354244OtherRN