Provider Demographics
NPI:1851781603
Name:WOODS, CAROL SUE
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:SUE
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 1:3891 MYSTIC TRL
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-8505
Mailing Address - Country:US
Mailing Address - Phone:989-401-1438
Mailing Address - Fax:
Practice Address - Street 1:3891 MYSTIC TRL
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-8505
Practice Address - Country:US
Practice Address - Phone:989-401-1438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker