Provider Demographics
NPI:1235322637
Name:WOODS, DEANNA (RN)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
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 1:362 LEWIS BROWN DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-9707
Mailing Address - Country:US
Mailing Address - Phone:606-677-6645
Mailing Address - Fax:
Practice Address - Street 1:362 LEWIS BROWN DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-9707
Practice Address - Country:US
Practice Address - Phone:606-677-6645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX716526171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator