Provider Demographics
NPI:1336701184
Name:WOOD, COLLEEN (NP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 EAST MARSHALL STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5415
Mailing Address - Country:US
Mailing Address - Phone:610-738-2500
Mailing Address - Fax:610-738-2540
Practice Address - Street 1:440 EAST MARSHALL STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5415
Practice Address - Country:US
Practice Address - Phone:610-738-2500
Practice Address - Fax:610-738-2540
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020092363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care