Provider Demographics
NPI:1861878035
Name:HAYWOOD, NAUDIA (LPN)
Entity type:Individual
Prefix:
First Name:NAUDIA
Middle Name:
Last Name:HAYWOOD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 BEACH 20TH ST APT 6H
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-3642
Mailing Address - Country:US
Mailing Address - Phone:646-354-1017
Mailing Address - Fax:
Practice Address - Street 1:407 BEACH 20TH ST APT 6H
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3642
Practice Address - Country:US
Practice Address - Phone:646-354-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2917301164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse