Provider Demographics
NPI:1528234663
Name:HAYDEN, MINDY (RN, LAC)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:RN, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 E BROWN RD
Mailing Address - Street 2:STE 17
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-4213
Mailing Address - Country:US
Mailing Address - Phone:480-641-5353
Mailing Address - Fax:480-641-9320
Practice Address - Street 1:2855 E BROWN RD
Practice Address - Street 2:STE 17
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85213-4213
Practice Address - Country:US
Practice Address - Phone:480-641-5353
Practice Address - Fax:480-641-9320
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0429171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist