Provider Demographics
NPI:1689028193
Name:WOODS, JASMINE LANETTE (RN)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:LANETTE
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 1:3152 SENECA FARM LN
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-8405
Mailing Address - Country:US
Mailing Address - Phone:678-531-3410
Mailing Address - Fax:100-000-0000
Practice Address - Street 1:3152 SENECA FARM LN
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-8405
Practice Address - Country:US
Practice Address - Phone:678-531-3410
Practice Address - Fax:100-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN242496163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse