Provider Demographics
NPI:1508084104
Name:WOODS, ANGEL MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:MARIE
Last Name:WOODS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 CHARLEDON AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-3814
Mailing Address - Country:US
Mailing Address - Phone:419-604-3383
Mailing Address - Fax:
Practice Address - Street 1:1924 CHARLEDON AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-3814
Practice Address - Country:US
Practice Address - Phone:419-604-3383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN111744164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse