MRS. CONNIE LOU HAYDEN (NPI# 1154355485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154355485 |
| Entity Type | Individual |
| Full Name | MRS. CONNIE LOU HAYDEN |
| Credential | LRD |
| Practice Address |
2101 Elm St N Fargo ND 58102-2417 |
| Mailing Address |
1218 2nd St W West Fargo ND 58078-2617 |
| Practice Telephone | 7012323241 |
| Mailing Telephone | 7012826074 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 481 | ND | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | STATE LICENSE # | 481 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437244936 | Connie Rae Hayden | Specialist | 130 Ravenglass Way, Colorado Springs, CO 80906 | 2006-10-03 |
| Street Address |
2101 ELM ST N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437143427 | Adam John Glazier | Internal Medicine | 2101 Elm St N, Fargo, ND 58102-2417 | 2005-09-06 |
| 1235740705 | Macy Jane Schindler | Occupational Therapist | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-08-10 |
| 1497363154 | Isaac Nies | Pharmacist | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-07-20 |
| 1376151597 | Paul Afanasi Polanski | Social Worker | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-07-14 |
| 1144848763 | Alexis Kokett | Pharmacist | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-07-09 |
| 1598396459 | Leah Roethel | Dietitian, Registered | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-01-30 |
| 1619508678 | Allison Wanner | Dietitian, Registered | 2101 Elm St N, Fargo, ND 58102-2417 | 2020-01-29 |
| 1720622822 | Nicole Marie Justice | Psychologist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-10-31 |
| 1750923033 | Samantha J. Tupy | Psychologist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-10-08 |
| 1639723232 | Madelyn Provost | Pharmacist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
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| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003446329 | Alexis Ann Allen | Dietitian, Registered | 1749 38th St S, Fargo, ND 58103-4442 | 2020-01-26 |
| 1487171245 | Presticor, Inc. | Dietitian, Registered | 2603 Kirsten Ln S Ste 104, Fargo, ND 58104-5204 | 2017-08-23 |
| 1558882092 | Stephanie E Scott | Dietitian, Registered | 2701 University Dr S, Fargo, ND 58103-6027 | 2017-07-06 |
| 1912234071 | Mary Monica Russell | Dietitian, Registered | 1702 East Rose Creek Parkway South, Fargo, ND 58104-6834 | 2009-11-11 |
| 1629221395 | Joan Pietron Carlisle | Dietitian, Registered | 2121 Elm Street North, Fargo Va Medical Center, Fargo, ND 58102 | 2008-10-28 |
| 1619133832 | Mary F Larson | Dietitian, Registered | 306 4th Street North, Fargo, ND 58102-4820 | 2008-08-07 |
| 1386829844 | Jackie R Griffiths | Dietitian, Registered | 4474 23rd Ave S Ste M, Fargo, ND 58104-8795 | 2008-01-03 |
| 1437103959 | Robin J Sickels | Dietitian, Registered | 737 Broadway, Fargo, ND 58122-0001 | 2006-05-20 |
| 1881295814 | Kelsey Kincaid | Dietitian, Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-11-05 |
| 1639786742 | Sam Lucas Scardigli | Dietitian, Registered | 1600 University Dr N, Fargo, ND 58105-2502 | 2020-09-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.