Provider Demographics
NPI:1669538393
Name:WOODS, CARLENE B
Entity type:Individual
Prefix:MRS
First Name:CARLENE
Middle Name:B
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3524 DICKEY MILL RD
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-9006
Mailing Address - Country:US
Mailing Address - Phone:336-578-8374
Mailing Address - Fax:336-578-0633
Practice Address - Street 1:3524 DICKEY MILL RD
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-9006
Practice Address - Country:US
Practice Address - Phone:336-578-8374
Practice Address - Fax:336-578-0633
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCFCL-001-034311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility