Provider Demographics
NPI:1821449521
Name:WOODHOUSE, CRISTINA R (MD)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:R
Last Name:WOODHOUSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 E GRAND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1977
Mailing Address - Country:US
Mailing Address - Phone:415-840-0560
Mailing Address - Fax:
Practice Address - Street 1:505 E GRAND AVE STE 200
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1977
Practice Address - Country:US
Practice Address - Phone:415-840-0560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-10692207Q00000X
FLME154158207Q00000X
TXU3440207Q00000X
IA45235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine