Provider Demographics
NPI:1770095663
Name:WOODS, PAMELA C (CNA)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:C
Last Name:WOODS
Suffix:
Gender:
Credentials:CNA
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:C
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNA
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38702-0202
Mailing Address - Country:US
Mailing Address - Phone:662-907-1200
Mailing Address - Fax:
Practice Address - Street 1:2593 AIRDALE DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38703-1918
Practice Address - Country:US
Practice Address - Phone:662-907-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA017512376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSA017512OtherCERTIFICATION LICENCE