Provider Demographics
NPI:1720787609
Name:WOOD, MARQUISHA
Entity Type:Individual
Prefix:
First Name:MARQUISHA
Middle Name:
Last Name:WOOD
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 1:32 HOLLAND CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SMITHS STATION
Mailing Address - State:AL
Mailing Address - Zip Code:36877-3390
Mailing Address - Country:US
Mailing Address - Phone:706-326-5292
Mailing Address - Fax:
Practice Address - Street 1:32 HOLLAND CREEK DR
Practice Address - Street 2:
Practice Address - City:SMITHS STATION
Practice Address - State:AL
Practice Address - Zip Code:36877-3390
Practice Address - Country:US
Practice Address - Phone:706-326-5292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion
Yes376J00000XNursing Service Related ProvidersHomemaker