Provider Demographics
NPI:1255845160
Name:JAMES, HAYDEN MICHELLE (RD, CD, CDCES)
Entity Type:Individual
Prefix:
First Name:HAYDEN
Middle Name:MICHELLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:RD, CD, CDCES
Other - Prefix:
Other - First Name:HAYDEN
Other - Middle Name:
Other - Last Name:GREENAWALT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:389 S 900 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2310
Mailing Address - Country:US
Mailing Address - Phone:385-282-2500
Mailing Address - Fax:918-619-4334
Practice Address - Street 1:389 S 900 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-2310
Practice Address - Country:US
Practice Address - Phone:385-282-2500
Practice Address - Fax:385-282-2551
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2128133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered