Provider Demographics
NPI:1043392756
Name:WOODLAND, SATU H (PMHCNS-BC)
Entity Type:Individual
Prefix:
First Name:SATU
Middle Name:H
Last Name:WOODLAND
Suffix:
Gender:F
Credentials:PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 S. ROOKERY LANE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706
Mailing Address - Country:US
Mailing Address - Phone:541-306-4191
Mailing Address - Fax:541-371-6410
Practice Address - Street 1:3152 S. BOWN WAY # 102
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706
Practice Address - Country:US
Practice Address - Phone:208-371-8040
Practice Address - Fax:866-371-6410
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200450045NP363LP0808X
IDCNS-68-A364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health