Provider Demographics
NPI:1518484153
Name:WOODS, KENDYLL RENEE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KENDYLL
Middle Name:RENEE
Last Name:WOODS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KENDYLL
Other - Middle Name:RENEE
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2111 NE 25TH AVE MS: JF5-167
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5961
Mailing Address - Country:US
Mailing Address - Phone:971-214-8607
Mailing Address - Fax:
Practice Address - Street 1:2111 NE 25TH AVE
Practice Address - Street 2:MS: JF5-167
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5961
Practice Address - Country:US
Practice Address - Phone:971-214-8607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201706577NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily