Provider Demographics
NPI:1679279822
Name:WOODS, MAUREEN ELLEN (RN)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ELLEN
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 1:6740 STATE HIGHWAY 58
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:NY
Mailing Address - Zip Code:13646-3160
Mailing Address - Country:US
Mailing Address - Phone:315-854-2839
Mailing Address - Fax:
Practice Address - Street 1:1003 PARK ST
Practice Address - Street 2:
Practice Address - City:OGDENSBURG
Practice Address - State:NY
Practice Address - Zip Code:13669-3911
Practice Address - Country:US
Practice Address - Phone:315-713-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY659586-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse