Provider Demographics
NPI:1922465004
Name:HAYWOOD, ROSEMARY ANNE (LAC)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:ANNE
Last Name:HAYWOOD
Suffix:
Gender:F
Credentials:LAC
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 7468
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-8945
Mailing Address - Country:US
Mailing Address - Phone:808-896-0368
Mailing Address - Fax:
Practice Address - Street 1:16859 KIOELE RD E
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:HI
Practice Address - Zip Code:96771
Practice Address - Country:US
Practice Address - Phone:808-896-0368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU707171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist