Provider Demographics
NPI:1942334008
Name:WOODRICK, TONI FULLER (RC, CNA)
Entity Type:Individual
Prefix:MS
First Name:TONI
Middle Name:FULLER
Last Name:WOODRICK
Suffix:
Gender:F
Credentials:RC, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 XANTHIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3510
Mailing Address - Country:US
Mailing Address - Phone:720-479-8532
Mailing Address - Fax:
Practice Address - Street 1:793 OLIVE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-5552
Practice Address - Country:US
Practice Address - Phone:303-394-4386
Practice Address - Fax:303-336-0966
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO174458376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide