Provider Demographics
NPI:1174515241
Name:HADLEY, KAY D (ARNP)
Entity type:Individual
Prefix:MRS
First Name:KAY
Middle Name:D
Last Name:HADLEY
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 1:7203 W DESCHUTES AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7777
Mailing Address - Country:US
Mailing Address - Phone:509-737-1880
Mailing Address - Fax:509-737-1879
Practice Address - Street 1:7211 W DESCHUTES AVE
Practice Address - Street 2:STE A
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7728
Practice Address - Country:US
Practice Address - Phone:509-735-4274
Practice Address - Fax:509-735-4312
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30002253174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB17772Medicare ID - Type UnspecifiedMC PROVIDER #
WAAB17770Medicare ID - Type UnspecifiedMC GROUP #
WACH4263Medicare ID - Type UnspecifiedRRMC GROUP#
WA500015080Medicare ID - Type UnspecifiedRRMC PROVIDER #
WAS58812Medicare UPIN