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General NPI Number Information
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NPI Number | 1255947388
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Entity Type | Individual
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Provider Name | MICHELLE VICTORIA HAYWOOD FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/23/2020
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 3910 5TH ST
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City | BALTIMORE
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State | MD
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Zip | 21225-2036
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Country | US
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Telephone | 443-726-3448
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3004
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City | BALTIMORE
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State | MD
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Zip | 21229-0004
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Country | US
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Telephone | 443-726-3448
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R208980
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License Number State | MD
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