Provider Demographics
NPI:1689213415
Name:WOOD, TENA LEE I (LVN)
Entity Type:Individual
Prefix:MS
First Name:TENA
Middle Name:LEE
Last Name:WOOD
Suffix:I
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 S. CRITES GRANBURY TX. 76048
Mailing Address - Street 2:302 S. CRITES GRANBURY TX. 76048
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048
Mailing Address - Country:US
Mailing Address - Phone:817-559-5308
Mailing Address - Fax:
Practice Address - Street 1:302 S. CRITES GRANBURY TX. 76048
Practice Address - Street 2:302 S. CRITES GRANBURY TX. 76048
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048
Practice Address - Country:US
Practice Address - Phone:817-559-5308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL060797164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse