Provider Demographics
NPI:1285684472
Name:HAYTON, MARTHA JANE (ARNP)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:JANE
Last Name:HAYTON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14630 DUANE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34610-1040
Mailing Address - Country:US
Mailing Address - Phone:727-856-0392
Mailing Address - Fax:
Practice Address - Street 1:22089 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-2364
Practice Address - Country:US
Practice Address - Phone:727-287-2784
Practice Address - Fax:727-669-9260
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2766802363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY090SOtherBCBS
Q41032Medicare UPIN
FLU4518ZMedicare ID - Type Unspecified