Provider Demographics
NPI:1821348244
Name:WOODS, SHREECE DUANYELLE
Entity Type:Individual
Prefix:
First Name:SHREECE
Middle Name:DUANYELLE
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 HARVISON RD
Mailing Address - Street 2:
Mailing Address - City:CHATOM
Mailing Address - State:AL
Mailing Address - Zip Code:36518-6209
Mailing Address - Country:US
Mailing Address - Phone:251-490-3825
Mailing Address - Fax:
Practice Address - Street 1:215 HARVISON RD
Practice Address - Street 2:
Practice Address - City:CHATOM
Practice Address - State:AL
Practice Address - Zip Code:36518-6209
Practice Address - Country:US
Practice Address - Phone:251-490-3825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman