Provider Demographics
NPI:1073387304
Name:WOODHAM, CHRISTIANA HOLLIS (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:HOLLIS
Last Name:WOODHAM
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:PO BOX 519
Mailing Address - Street 2:
Mailing Address - City:MIDLAND CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36350-0519
Mailing Address - Country:US
Mailing Address - Phone:334-432-0181
Mailing Address - Fax:
Practice Address - Street 1:11306 S COUNTY ROAD 67
Practice Address - Street 2:
Practice Address - City:MIDLAND CITY
Practice Address - State:AL
Practice Address - Zip Code:36350-4088
Practice Address - Country:US
Practice Address - Phone:334-432-0181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-189981163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse