Provider Demographics
NPI:1558310607
Name:WOOD, NANCY E (RN)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:E
Last Name:WOOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11326 SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:ARBOR VITAE
Mailing Address - State:WI
Mailing Address - Zip Code:54568-9225
Mailing Address - Country:US
Mailing Address - Phone:715-358-9679
Mailing Address - Fax:
Practice Address - Street 1:2045 TOWNSITE RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:WI
Practice Address - Zip Code:54557
Practice Address - Country:US
Practice Address - Phone:715-686-7443
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38244200Medicaid