Provider Demographics
NPI:1932307782
Name:WOODS, MICHAEL RAY (RN)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RAY
Last Name:WOODS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 E 41ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2553
Mailing Address - Country:US
Mailing Address - Phone:918-694-7973
Mailing Address - Fax:918-660-3143
Practice Address - Street 1:4502 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2553
Practice Address - Country:US
Practice Address - Phone:918-694-7973
Practice Address - Fax:918-660-3143
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0064849163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult