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General NPI Number Information
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NPI Number | 1942672704
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Entity Type | Individual
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Provider Name | REBEKAH HAYWOOD FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 90 MAIN ST
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City | WESTERNPORT
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State | MD
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Zip | 21562-1437
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Country | US
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Telephone | 301-359-5145
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Fax | 301-359-5178
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Provider Business Mailing Address
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Address Line | 51 MAIN ST STE 4
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City | WESTERNPORT
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State | MD
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Zip | 21562-1400
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Country | US
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Telephone | 717-635-0595
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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 | APRN84484-NP-C
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R219448
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License Number State | MD
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