Provider Demographics
NPI:1376788745
Name:WOODS, KEVIN (RN)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:WOODS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 ELYSIAN FIELDS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-8511
Mailing Address - Country:US
Mailing Address - Phone:504-620-2453
Mailing Address - Fax:504-620-2454
Practice Address - Street 1:719 ELYSIAN FIELDS AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-8511
Practice Address - Country:US
Practice Address - Phone:504-620-2453
Practice Address - Fax:504-620-2454
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN098656163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult