Provider Demographics
NPI:1710284260
Name:WOODWARD, ALEXANDRIA ROSE (RN)
Entity Type:Individual
Prefix:MISS
First Name:ALEXANDRIA
Middle Name:ROSE
Last Name:WOODWARD
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 1:44 BREFNI ST
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-1410
Mailing Address - Country:US
Mailing Address - Phone:347-739-3043
Mailing Address - Fax:
Practice Address - Street 1:44 BREFNI ST
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-1410
Practice Address - Country:US
Practice Address - Phone:347-739-3043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY592058-1163WG0000X, 163WM0705X, 163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic