Provider Demographics
NPI:1952126195
Name:WOODLAND, NATHANIEL SR
Entity type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:
Last Name:WOODLAND
Suffix:SR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:NATHANIEL
Other - Middle Name:
Other - Last Name:WOODLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2930 K ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-1163
Mailing Address - Country:US
Mailing Address - Phone:202-580-3989
Mailing Address - Fax:
Practice Address - Street 1:2930 K ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1163
Practice Address - Country:US
Practice Address - Phone:202-580-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant