Provider Demographics
NPI:1497382030
Name:WOODS, TOYA JAMILLAH (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:TOYA
Middle Name:JAMILLAH
Last Name:WOODS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 SUPERIOR AVE
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-3411
Mailing Address - Country:US
Mailing Address - Phone:773-209-3995
Mailing Address - Fax:
Practice Address - Street 1:1009 5TH AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-1004
Practice Address - Country:US
Practice Address - Phone:219-473-0722
Practice Address - Fax:219-473-0728
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71009867A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care