Provider Demographics
NPI:1821571886
Name:DHLIWAYO, THANDIWE
Entity type:Individual
Prefix:
First Name:THANDIWE
Middle Name:
Last Name:DHLIWAYO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 FRESH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EPPING
Mailing Address - State:NH
Mailing Address - Zip Code:03042-2222
Mailing Address - Country:US
Mailing Address - Phone:603-842-7760
Mailing Address - Fax:844-222-8864
Practice Address - Street 1:31 FRESH RIVER RD
Practice Address - Street 2:
Practice Address - City:EPPING
Practice Address - State:NH
Practice Address - Zip Code:03042-2222
Practice Address - Country:US
Practice Address - Phone:603-842-7760
Practice Address - Fax:844-222-8864
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH069915-21163W00000X
NH069915-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse