Provider Demographics
NPI:1932752136
Name:HAYWOOD, KIMBERLY N (ARNP, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:N
Last Name:HAYWOOD
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 NW 33RD ST
Mailing Address - Street 2:STE 400
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1940
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8300 NW 33RD ST STE 400
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1940
Practice Address - Country:US
Practice Address - Phone:904-229-7396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704366368363LF0000X
FL11002220363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty