Provider Demographics
NPI:1811785165
Name:WOODARD, JALYNNE
Entity type:Individual
Prefix:
First Name:JALYNNE
Middle Name:
Last Name:WOODARD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28402 SUNNY BROOK RD
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57747-7338
Mailing Address - Country:US
Mailing Address - Phone:208-697-1065
Mailing Address - Fax:
Practice Address - Street 1:500 N 5TH ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:SD
Practice Address - Zip Code:57747-1480
Practice Address - Country:US
Practice Address - Phone:605-475-2085
Practice Address - Fax:605-745-2079
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide