Provider Demographics
NPI:1083910269
Name:WOOD, PAULA R (CRNA)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:R
Last Name:WOOD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:R
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:5336 STADIUM TRACE PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4581
Mailing Address - Country:US
Mailing Address - Phone:205-795-3411
Mailing Address - Fax:855-647-9621
Practice Address - Street 1:810 SAINT VINCENTS DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1601
Practice Address - Country:US
Practice Address - Phone:205-939-7143
Practice Address - Fax:205-939-2505
Is Sole Proprietor?:No
Enumeration Date:2011-02-04
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-109487367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered