Provider Demographics
NPI:1053545160
Name:HAYDEN, JANE BESHORE (CNM)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:BESHORE
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:BESHORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8105 ADAMS DR STE B
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-8625
Mailing Address - Country:US
Mailing Address - Phone:717-482-8115
Mailing Address - Fax:717-482-8364
Practice Address - Street 1:8105 ADAMS DR STE B
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-8625
Practice Address - Country:US
Practice Address - Phone:717-482-8115
Practice Address - Fax:717-482-8364
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA602893163W00000X
PAMW010269367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022927580003Medicaid