Provider Demographics
NPI:1245611458
Name:WOODARD ERVIN, WILLA ANNE (CPM, LDM/PMH-C)
Entity Type:Individual
Prefix:
First Name:WILLA
Middle Name:ANNE
Last Name:WOODARD ERVIN
Suffix:
Gender:F
Credentials:CPM, LDM/PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1453 REDWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5523
Mailing Address - Country:US
Mailing Address - Phone:541-916-8333
Mailing Address - Fax:541-843-1010
Practice Address - Street 1:1453 REDWOOD CIR
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5523
Practice Address - Country:US
Practice Address - Phone:541-210-0134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife