Provider Demographics
NPI:1821315342
Name:WOODY, BARBARA S (NP-C)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:S
Last Name:WOODY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5659 S REX RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3821
Mailing Address - Country:US
Mailing Address - Phone:901-763-3636
Mailing Address - Fax:901-763-3694
Practice Address - Street 1:5659 S REX RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3821
Practice Address - Country:US
Practice Address - Phone:901-763-3636
Practice Address - Fax:901-763-3694
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14951363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily