MEDICARE: JACINTA WOOD

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	175M00000X	Lay Midwife		NV
2	374J00000X	Doula		NV

General Provider Information

NPI Number	:	1689437550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACINTA WOOD

Provider Business Mailing Address
First Line	:	8610 S MARYLAND PKWY APT 1013
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2710
Country	:	US
Telephone Number	:	702-415-9073
Fax Number	:

Provider Business Practice Location Address
First Line	:	8610 S MARYLAND PKWY APT 1013
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2710
Country	:	US
Telephone Number	:	702-415-9073
Fax Number	:

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

Provider Enumeration Date	:	02/02/2024
Last Update Date	:	02/02/2024

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Directions to “ JACINTA WOOD ” Practice Location

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