Haywood, Theresa

Haywood, Theresa is an individual health care provider with primary practice located at 275 Route 30 N , Bomoseen VT 05732-9647. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Haywood, Theresa can be contacted via phone (802) 468-5641.

Contact Information

Primary practice address
275 Route 30 N Bomoseen VT 05732-9647
Phone: (802) 468-5641
Fax: (802) 468-2923
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 101.0103560 Vermont
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 101.0103560 Vermont

Profile Details

NPI number 1891196804
LBN Legal business name Haywood, Theresa
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2014
Last updated Dec 13th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891196804 NPPES
Vermont MEDICAID 1023840

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