Healthcare Provider Details

I. General information

NPI: 1659762714
Provider Name (Legal Business Name): LAYWELL TEDOE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N FRONT ST
NEW BEDFORD MA
02740-7327
US

IV. Provider business mailing address

75 N MAIN ST
RANDOLPH MA
02368-4605
US

V. Phone/Fax

Practice location:
  • Phone: 774-628-1000
  • Fax:
Mailing address:
  • Phone: 774-257-6565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN2269898
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN2269898
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024172332
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2269898
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: