Provider Demographics
NPI:1801585070
Name:HAYDEN, LEAH SUZANNA (NP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:SUZANNA
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:S
Other - Last Name:LOOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3841 PIPER ST STE T100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4674
Mailing Address - Country:US
Mailing Address - Phone:907-561-3211
Mailing Address - Fax:907-561-4652
Practice Address - Street 1:3841 PIPER ST STE T100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4674
Practice Address - Country:US
Practice Address - Phone:907-561-3211
Practice Address - Fax:907-561-4652
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK204684363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care