Provider Demographics
NPI:1942672795
Name:WOOD, ELISE (PA-C)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:
Other - Last Name:FURMANSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:10200 N 92ND ST STE 225
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4536
Mailing Address - Country:US
Mailing Address - Phone:806-974-8244
Mailing Address - Fax:480-697-4825
Practice Address - Street 1:10200 N 92ND ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4534
Practice Address - Country:US
Practice Address - Phone:480-697-4824
Practice Address - Fax:480-697-4825
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6245363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical