Provider Demographics
NPI:1154118206
Name:WOODWARD, LAURIE ANNE
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:ANNE
Last Name:WOODWARD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 MOUNT OLIVE RD
Mailing Address - Street 2:
Mailing Address - City:TOMS BROOK
Mailing Address - State:VA
Mailing Address - Zip Code:22660-1926
Mailing Address - Country:US
Mailing Address - Phone:571-420-3644
Mailing Address - Fax:
Practice Address - Street 1:448 MOUNT OLIVE RD
Practice Address - Street 2:
Practice Address - City:TOMS BROOK
Practice Address - State:VA
Practice Address - Zip Code:22660-1926
Practice Address - Country:US
Practice Address - Phone:571-420-3644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001304571163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health