Provider Demographics
NPI:1407924350
Name:WOODS, DENISE R (FNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:R
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:PO BOX 751907
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38175-1907
Mailing Address - Country:US
Mailing Address - Phone:901-516-3872
Mailing Address - Fax:901-346-2892
Practice Address - Street 1:1264 WESLEY DRIVE SUITE 103
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38175
Practice Address - Country:US
Practice Address - Phone:901-516-3872
Practice Address - Fax:901-346-2892
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11743363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q58097Medicare UPIN
3642027Medicare ID - Type Unspecified