Provider Demographics
NPI:1598204208
Name:WOODS, MONIQUE (RN)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:WOODS
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 1:201 POWELL MILL RD
Mailing Address - Street 2:APT A102
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-1526
Mailing Address - Country:US
Mailing Address - Phone:205-249-6476
Mailing Address - Fax:
Practice Address - Street 1:201 POWELL MILL RD
Practice Address - Street 2:APT A102
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-1526
Practice Address - Country:US
Practice Address - Phone:205-249-6476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC233648163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health