Provider Demographics
NPI:1225713654
Name:WOODMAN, AMY LAUREN (FNP, RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LAUREN
Last Name:WOODMAN
Suffix:
Gender:F
Credentials:FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2589 E 24TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-3226
Mailing Address - Country:US
Mailing Address - Phone:928-275-3213
Mailing Address - Fax:928-268-0148
Practice Address - Street 1:2589 E 24TH ST STE 2
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-3226
Practice Address - Country:US
Practice Address - Phone:928-275-3213
Practice Address - Fax:928-268-0148
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ288247163W00000X, 207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine