Provider Demographics
NPI:1710047741
Name:WOODS, JODIE B (CFA)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:B
Last Name:WOODS
Suffix:
Gender:F
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 N CURTIS RD
Mailing Address - Street 2:STE 304
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-1338
Mailing Address - Country:US
Mailing Address - Phone:208-342-4263
Mailing Address - Fax:208-375-0597
Practice Address - Street 1:901 N CURTIS RD
Practice Address - Street 2:STE 304
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-1338
Practice Address - Country:US
Practice Address - Phone:208-342-4263
Practice Address - Fax:208-375-0597
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
000000174400000X
ID52063246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010143207OtherBLUE SHIELD