Provider Demographics
NPI:1609117217
Name:HAYWARD, JILL MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:MARIE
Last Name:HAYWARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 606
Mailing Address - Street 2:6845 EDINGER DR
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214
Mailing Address - Country:US
Mailing Address - Phone:315-445-8329
Mailing Address - Fax:315-445-8307
Practice Address - Street 1:6845 EDINGER DR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214
Practice Address - Country:US
Practice Address - Phone:315-445-8329
Practice Address - Fax:315-445-8307
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4241471163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool