Provider Demographics
NPI:1700260676
Name:WOODS, JENNIFER (DNP, FNP-C, APRN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:DNP, FNP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:STEARNS
Mailing Address - State:KY
Mailing Address - Zip Code:42647-0173
Mailing Address - Country:US
Mailing Address - Phone:606-825-0000
Mailing Address - Fax:606-825-0024
Practice Address - Street 1:76 MEDICAL LANE
Practice Address - Street 2:
Practice Address - City:WHITLEY CITY
Practice Address - State:KY
Practice Address - Zip Code:42653
Practice Address - Country:US
Practice Address - Phone:606-825-0000
Practice Address - Fax:606-825-0024
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-10
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY13590864OtherCAQH