Provider Demographics
NPI:1871822437
Name:WOOD, GAIL B (CNP)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:B
Last Name:WOOD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3439 GRANITE CIR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1161
Mailing Address - Country:US
Mailing Address - Phone:419-843-7996
Mailing Address - Fax:419-841-7725
Practice Address - Street 1:3439 GRANITE CIR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1161
Practice Address - Country:US
Practice Address - Phone:419-843-7996
Practice Address - Fax:419-841-7725
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA0809435363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3032471Medicaid
OH000000643624OtherANTHEM BCBS
OHWONP34291Medicare PIN
OHH024570Medicare PIN