Provider Demographics
NPI:1376187252
Name:WOODS, SHEA LEIGH (FNP)
Entity Type:Individual
Prefix:
First Name:SHEA
Middle Name:LEIGH
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 1:3200 W STATE HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-2449
Mailing Address - Country:US
Mailing Address - Phone:903-875-2188
Mailing Address - Fax:
Practice Address - Street 1:3200 W STATE HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2449
Practice Address - Country:US
Practice Address - Phone:903-875-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143729363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily