Provider Demographics
NPI:1013154525
Name:WOOD, RACHEL LYNN (RN, CNM)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:WOOD
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MADIGAN ARMY MEDICAL CTR
Mailing Address - Street 2:FITZSIMMONS DRIVE
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-968-1406
Mailing Address - Fax:
Practice Address - Street 1:3480 CENTENNIAL BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-4087
Practice Address - Country:US
Practice Address - Phone:800-230-7526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0999286-CNM367A00000X
TNRN000162458163W00000X
CORN.1693313163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000223279Medicaid