Provider Demographics
NPI:1821556119
Name:WOOD, ASHLEIGH MICHELLE
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:MICHELLE
Last Name:WOOD
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 1:121 QUAIL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-4836
Mailing Address - Country:US
Mailing Address - Phone:903-647-1987
Mailing Address - Fax:
Practice Address - Street 1:121 QUAIL RIDGE RD
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-4836
Practice Address - Country:US
Practice Address - Phone:903-647-1987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX947158163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse