Provider Demographics
NPI:1093590283
Name:ATWOOD, ALONDA MARIE (ADMINISTRATOR)
Entity Type:Individual
Prefix:
First Name:ALONDA
Middle Name:MARIE
Last Name:ATWOOD
Suffix:
Gender:F
Credentials:ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 KYLE XING UNIT C7
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6157
Mailing Address - Country:US
Mailing Address - Phone:737-235-2795
Mailing Address - Fax:
Practice Address - Street 1:3601 KYLE XING UNIT C7
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6157
Practice Address - Country:US
Practice Address - Phone:737-235-2795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX022442374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide