Individual
THERESA HAYWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
275 ROUTE 30 N, BOMOSEEN, VT 05732-9647
(802) 468-5641
(802) 468-2923
Mailing address
71 ALLEN ST, STE 403, RUTLAND, VT 05701-4570
(802) 772-4414
(802) 772-7973
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
101.0103560
VT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
101.0103560
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023840
—
VT
Enumeration date
09/09/2014
Last updated
12/13/2021
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