Provider Demographics
NPI:1225231764
Name:WOODS, JUDITH A (FNP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:WOODS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4849 PAULSEN ST STE 314
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4426
Mailing Address - Country:US
Mailing Address - Phone:912-356-3363
Mailing Address - Fax:912-354-3332
Practice Address - Street 1:4849 PAULSEN ST STE 314
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4426
Practice Address - Country:US
Practice Address - Phone:912-354-3363
Practice Address - Fax:912-354-3332
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN074147363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000534652DMedicaid
GAP00406211OtherRR MEDICARE
GAP00406211OtherRR MEDICARE
GA50BBLTZMedicare PIN