Provider Demographics
NPI:1982452330
Name:WOODARD, HALEY NOEL (RN)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:NOEL
Last Name:WOODARD
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 1:73 ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-4317
Mailing Address - Country:US
Mailing Address - Phone:203-947-1390
Mailing Address - Fax:
Practice Address - Street 1:245 ALVORD PARK RD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3493
Practice Address - Country:US
Practice Address - Phone:203-947-1390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT176349163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program