Provider Demographics
NPI:1205250503
Name:WOOD, AMY RENEE I (CRNA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:RENEE
Last Name:WOOD
Suffix:I
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:320 ALPENGLOW LN
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-8506
Mailing Address - Country:US
Mailing Address - Phone:406-222-3541
Mailing Address - Fax:406-823-6434
Practice Address - Street 1:621 3RD ST S
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:MT
Practice Address - Zip Code:59230-2604
Practice Address - Country:US
Practice Address - Phone:406-228-3500
Practice Address - Fax:406-228-3680
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT31354367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered