Healthcare Provider Details

I. General information

NPI: 1861451627
Provider Name (Legal Business Name): PAMELA M HAYWARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53585 NOKOMIS RD
ASHLAND WI
54806-4272
US

IV. Provider business mailing address

53585 NOKOMIS RD
ASHLAND WI
54806-4272
US

V. Phone/Fax

Practice location:
  • Phone: 715-682-7133
  • Fax:
Mailing address:
  • Phone: 715-682-7133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2569
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: