Provider Demographics
NPI:1093150823
Name:WOODS, WENDY ALISON (RN)
Entity Type:Individual
Prefix:MISS
First Name:WENDY
Middle Name:ALISON
Last Name:WOODS
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 1:4735 GOVERNMENT ST APT 324
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-5871
Mailing Address - Country:US
Mailing Address - Phone:225-328-1626
Mailing Address - Fax:
Practice Address - Street 1:4735 GOVERNMENT ST APT 324
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-5871
Practice Address - Country:US
Practice Address - Phone:225-328-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA163W00000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program