Provider Demographics
NPI:1336626241
Name:HAYWOOD, CATHERINE TOMBERLIN (DNP, FNP-BC, MSN, RN)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:TOMBERLIN
Last Name:HAYWOOD
Suffix:
Gender:F
Credentials:DNP, FNP-BC, MSN, RN
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:ELIZABETH
Other - Last Name:TOMBERLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:138 GARDNERS MILL RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-3792
Mailing Address - Country:US
Mailing Address - Phone:912-667-8901
Mailing Address - Fax:
Practice Address - Street 1:138 GARDNERS MILL RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-3792
Practice Address - Country:US
Practice Address - Phone:912-667-8901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN256596163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse