Provider Demographics
NPI:1821776956
Name:WODWASKI, NADINE (DNP, MSN-ED, ACNS, R)
Entity Type:Individual
Prefix:DR
First Name:NADINE
Middle Name:
Last Name:WODWASKI
Suffix:
Gender:F
Credentials:DNP, MSN-ED, ACNS, R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3166 OTTER DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-5727
Mailing Address - Country:US
Mailing Address - Phone:248-719-8165
Mailing Address - Fax:
Practice Address - Street 1:3166 OTTER DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-5727
Practice Address - Country:US
Practice Address - Phone:248-719-8165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704190084163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool