Provider Demographics
NPI:1578748992
Name:WOODSON, ADRIAN MAUREEN (APRN-BC)
Entity Type:Individual
Prefix:MRS
First Name:ADRIAN
Middle Name:MAUREEN
Last Name:WOODSON
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39926 WESTCLIFF ST
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-5297
Mailing Address - Country:US
Mailing Address - Phone:661-575-0383
Mailing Address - Fax:661-575-0373
Practice Address - Street 1:39926 WESTCLIFF ST
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-5297
Practice Address - Country:US
Practice Address - Phone:661-575-0383
Practice Address - Fax:661-575-0373
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17250363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily