Provider Demographics
NPI:1972699098
Name:WOOD, HATTIE W (RN)
Entity Type:Individual
Prefix:MS
First Name:HATTIE
Middle Name:W
Last Name:WOOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MARSH CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2357
Mailing Address - Country:US
Mailing Address - Phone:919-220-5340
Mailing Address - Fax:
Practice Address - Street 1:414 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-3720
Practice Address - Country:US
Practice Address - Phone:919-560-7635
Practice Address - Fax:919-560-7716
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC076248163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health