Provider Demographics
NPI:1912688946
Name:WOODWARD, ADRIANA MULLER (FNP-C)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:MULLER
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 EDGEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-1663
Mailing Address - Country:US
Mailing Address - Phone:209-552-1887
Mailing Address - Fax:
Practice Address - Street 1:917 OAKDALE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4593
Practice Address - Country:US
Practice Address - Phone:808-657-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily