Provider Demographics
NPI:1346212446
Name:WOODS, OLGA G (FNP)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:G
Last Name:WOODS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 MURRAY DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37821-3631
Mailing Address - Country:US
Mailing Address - Phone:423-623-1057
Mailing Address - Fax:423-625-8620
Practice Address - Street 1:207 MURRAY DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-3631
Practice Address - Country:US
Practice Address - Phone:423-623-1057
Practice Address - Fax:423-625-8620
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN45134163W00000X
TNAPN5422363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4039236OtherBCBST
TN1000028162OtherPHP TENNCARE
TN4039232OtherBCBST
TN3346338Medicaid
TN4039237OtherBCBST
TN4039239OtherBCBST/BLUECARE TENNCARE
TN4039232OtherBCBST