Provider Demographics
NPI:1134903321
Name:WOODS, ASHLEY NICOLE (FNP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:WOODS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:LASSETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 BROADFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-8642
Mailing Address - Country:US
Mailing Address - Phone:662-809-2419
Mailing Address - Fax:
Practice Address - Street 1:140 BROADFIELD DR
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-8642
Practice Address - Country:US
Practice Address - Phone:662-809-2419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSF07231195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily