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NPI Code Detail

MEDICARE: GAYLE LYNN WOODY RN

MEDICARE: GAYLE LYNN WOODY RN
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
1163WG0000XGeneral Practice Registered Nurse2007028006MO

General Provider Information

NPI Number : 1336954197
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAYLE LYNN WOODY RN
Provider Business Mailing Address
First Line : 22512 S 425 RD
Second Line :
City : BRONAUGH
State : MO
Zip : 64728-7565
Country : US
Telephone Number : 417-667-1940
Fax Number :
Provider Business Practice Location Address
First Line : 1220 E AUSTIN ST
Second Line :
City : NEVADA
State : MO
Zip : 64772-3927
Country : US
Telephone Number : 816-922-2635
Fax Number : 816-922-4870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2025
Last Update Date : 02/10/2025

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