Provider Demographics
NPI:1639909971
Name:WOODLEY, REBECCA CLAIRE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CLAIRE
Last Name:WOODLEY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 KIMBRO DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-6041
Mailing Address - Country:US
Mailing Address - Phone:512-550-3348
Mailing Address - Fax:
Practice Address - Street 1:730 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6536
Practice Address - Country:US
Practice Address - Phone:225-201-9862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201891363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health