Provider Demographics
NPI:1285814806
Name:WOODE, WINIFRED NAANA (RN)
Entity Type:Individual
Prefix:
First Name:WINIFRED
Middle Name:NAANA
Last Name:WOODE
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 1:1896 124TH LN NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-7919
Mailing Address - Country:US
Mailing Address - Phone:763-862-9140
Mailing Address - Fax:
Practice Address - Street 1:1896 124TH LN NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-7919
Practice Address - Country:US
Practice Address - Phone:763-862-9140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 139214-4163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice