Provider Demographics
NPI:1750349353
Name:HAYWARD, MESHELLIA A (FNP)
Entity type:Individual
Prefix:
First Name:MESHELLIA
Middle Name:A
Last Name:HAYWARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 N IRBY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-2808
Mailing Address - Country:US
Mailing Address - Phone:843-667-9414
Mailing Address - Fax:843-667-1362
Practice Address - Street 1:86 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:GREELEYVILLE
Practice Address - State:SC
Practice Address - Zip Code:29056
Practice Address - Country:US
Practice Address - Phone:843-426-2335
Practice Address - Fax:843-426-2346
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1814363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1063Medicaid
SCQ02916Medicare UPIN