Provider Demographics
NPI:1770369282
Name:WOOD, JANINE LEE (MSN, APRN,FNP-BC)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:LEE
Last Name:WOOD
Suffix:
Gender:F
Credentials:MSN, APRN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 7TH ST NW
Mailing Address - Street 2:
Mailing Address - City:BOGATA
Mailing Address - State:TX
Mailing Address - Zip Code:75417-2441
Mailing Address - Country:US
Mailing Address - Phone:903-249-1956
Mailing Address - Fax:
Practice Address - Street 1:147 N COLLEGIATE DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-4842
Practice Address - Country:US
Practice Address - Phone:903-784-6300
Practice Address - Fax:903-784-6310
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1134374207Q00000X
TX698492163W00000X, 163WH0200X, 163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WH1000XNursing Service ProvidersRegistered NurseHospice