Provider Demographics
NPI:1568643674
Name:WOODARD, SHEILA M (RN)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:M
Last Name:WOODARD
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 1:7321 HIGHWAY 4
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:LA
Mailing Address - Zip Code:71068-2703
Mailing Address - Country:US
Mailing Address - Phone:318-894-8484
Mailing Address - Fax:
Practice Address - Street 1:1635 MARVEL ST
Practice Address - Street 2:
Practice Address - City:COUSHATTA
Practice Address - State:LA
Practice Address - Zip Code:71019-9022
Practice Address - Country:US
Practice Address - Phone:318-932-9980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN087847163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1417246Medicaid