Provider Demographics
NPI:1023323888
Name:HAYDEN, BRIANA COSS
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:COSS
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:DEE
Other - Last Name:COSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2828 OLD HICKORY BLVD
Mailing Address - Street 2:APT 105
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-3719
Mailing Address - Country:US
Mailing Address - Phone:404-583-0575
Mailing Address - Fax:
Practice Address - Street 1:2828 OLD HICKORY BLVD
Practice Address - Street 2:APT 105
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-3719
Practice Address - Country:US
Practice Address - Phone:404-583-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3201050742719183700000X
TN0000038317183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician