Provider Demographics
NPI:1073764353
Name:WOODS-TODD, SHARON H (RNCPAN REGISTERED N)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:H
Last Name:WOODS-TODD
Suffix:
Gender:F
Credentials:RNCPAN REGISTERED N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 WOODRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-2209
Mailing Address - Country:US
Mailing Address - Phone:601-613-4332
Mailing Address - Fax:601-956-4648
Practice Address - Street 1:56 WOODRIDGE PL
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-2209
Practice Address - Country:US
Practice Address - Phone:601-613-4332
Practice Address - Fax:601-956-4648
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
09986867Medicare UPIN