MEDICARE: VICTORIA WOODARD LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	L17328	ND

General Provider Information

NPI Number	:	1023954682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA WOODARD LPN

Provider Business Mailing Address
First Line	:	4133 30TH AVE S STE 103
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58104-8421
Country	:	US
Telephone Number	:	701-499-4847
Fax Number	:	701-433-1882

Provider Business Practice Location Address
First Line	:	4133 30TH AVE S STE 103
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58104-8421
Country	:	US
Telephone Number	:	701-499-4847
Fax Number	:	701-433-1882

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	04/27/2026

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Directions to “ VICTORIA WOODARD LPN” Practice Location

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