Provider Demographics
NPI:1588309355
Name:LANDON, HAYDEN (MS, RDN, LD)
Entity type:Individual
Prefix:
First Name:HAYDEN
Middle Name:
Last Name:LANDON
Suffix:
Gender:F
Credentials:MS, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4267 LONG LAKE DR APT 9203
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-9138
Mailing Address - Country:US
Mailing Address - Phone:417-718-1245
Mailing Address - Fax:
Practice Address - Street 1:7794 5 MILE RD BLDG B
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2368
Practice Address - Country:US
Practice Address - Phone:513-977-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09721133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered