Provider Demographics
NPI:1093208951
Name:HAYDEN, LAUREN TIFFANY (PA)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:TIFFANY
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:TIFFANY
Other - Last Name:BLANKENSHIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:403 N STATE OF FRANKLIN RD WOODRIDGE HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604
Mailing Address - Country:US
Mailing Address - Phone:423-340-2276
Mailing Address - Fax:
Practice Address - Street 1:403 N STATE OF FRANKLIN RD WOODRIDGE HOSPITAL
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604
Practice Address - Country:US
Practice Address - Phone:423-340-2276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant