Provider Demographics
NPI:1396830899
Name:WOOD, MARY ANGELA (ANP-BC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ANGELA
Last Name:WOOD
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:BUCCI
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14 W. HUNTER CREEK LANE
Mailing Address - Street 2:
Mailing Address - City:WEST GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19390
Mailing Address - Country:US
Mailing Address - Phone:610-869-8435
Mailing Address - Fax:
Practice Address - Street 1:1601 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4917
Practice Address - Country:US
Practice Address - Phone:610-299-5209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN287668L163WM0705X
PASP010321363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner