Provider Demographics
NPI:1184598765
Name:SUPERIOR WOUND CARE
Entity type:Organization
Organization Name:SUPERIOR WOUND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-623-0828
Mailing Address - Street 1:2 N CENTRAL AVE STE 1800
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-2139
Mailing Address - Country:US
Mailing Address - Phone:833-968-6370
Mailing Address - Fax:855-582-1326
Practice Address - Street 1:1000 HIGHLAND COLONY PKWY STE 5203
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2079
Practice Address - Country:US
Practice Address - Phone:833-968-6370
Practice Address - Fax:855-582-1326
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADEPT CONSULTING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty