Provider Demographics
NPI:1467139691
Name:WOODFORD, LORI (RN, NC-BC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:WOODFORD
Suffix:
Gender:F
Credentials:RN, NC-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22545 COUNTY ROAD 638
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-3608
Mailing Address - Country:US
Mailing Address - Phone:214-794-1315
Mailing Address - Fax:
Practice Address - Street 1:22545 COUNTY ROAD 638
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-3608
Practice Address - Country:US
Practice Address - Phone:214-794-1315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX657358163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse