Provider Demographics
NPI:1245480771
Name:WOODS, KEITH (LPN)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:WOODS
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 DANVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-1244
Mailing Address - Country:US
Mailing Address - Phone:740-222-5496
Mailing Address - Fax:
Practice Address - Street 1:416 DANVILLE PIKE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-1244
Practice Address - Country:US
Practice Address - Phone:740-222-5496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-20
Last Update Date:2008-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN105106164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse