Provider Demographics
NPI:1053849406
Name:WOODY, AMY NICOLE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:NICOLE
Last Name:WOODY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 AGAVE DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-2258
Mailing Address - Country:US
Mailing Address - Phone:832-334-9847
Mailing Address - Fax:
Practice Address - Street 1:5252 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7822
Practice Address - Country:US
Practice Address - Phone:469-764-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134700363LF0000X, 207PE0004X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No208000000XAllopathic & Osteopathic PhysiciansPediatrics