Provider Demographics
NPI:1962445585
Name:GREEN-HADDEN, JOY M (NP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:M
Last Name:GREEN-HADDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 634760
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:865-292-3000
Mailing Address - Fax:
Practice Address - Street 1:2400 PATTERSON ST
Practice Address - Street 2:SUITE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1562
Practice Address - Country:US
Practice Address - Phone:615-342-5900
Practice Address - Fax:615-342-5912
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN6515363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN406850OtherBLUECROSS
P00670754OtherRR MEDICARE
TNP00037520OtherRAILROAD MEDICARE
TN33491421Medicare PIN
P00670754OtherRR MEDICARE
TNP00037520OtherRAILROAD MEDICARE