Provider Demographics
NPI:1811395601
Name:WOODS, MOLLY MCGOWAN (AG-ACNP)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:MCGOWAN
Last Name:WOODS
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:ELIZABETH
Other - Last Name:MCGOWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1215 21ST AVE S
Practice Address - Street 2:SUITE 5209 MEDICAL CENTER EAST
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-8802
Practice Address - Country:US
Practice Address - Phone:615-322-2318
Practice Address - Fax:615-343-9604
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN177301163W00000X
TN19267363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ011670Medicaid
TN10311I1780Medicare PIN