Provider Demographics
NPI:1245327238
Name:WOODS, GLORIA G (NP)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:G
Last Name:WOODS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2107
Mailing Address - Country:US
Mailing Address - Phone:423-266-6751
Mailing Address - Fax:423-763-4650
Practice Address - Street 1:1028 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2107
Practice Address - Country:US
Practice Address - Phone:423-266-6751
Practice Address - Fax:423-763-4650
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN5166363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00185849OtherPALMETTO R.R. M.C.
TN3929694Medicare ID - Type Unspecified
TNP00185849OtherPALMETTO R.R. M.C.