MEDICARE: MS. MICHEL R WOODS RN, CNOR, RNFA

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	163W00000X	Registered Nurse	RN117776	AZ
2	163WR0006X	Registered Nurse First Assistant	RN117776	AZ

General Provider Information

NPI Number	:	1790729788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHEL R WOODS RN, CNOR, RNFA

Provider Business Mailing Address
First Line	:	PO BOX 958
Second Line	:
City	:	HIGLEY
State	:	AZ
Zip	:	85236-0958
Country	:	US
Telephone Number	:	480-577-3808
Fax Number	:

Provider Business Practice Location Address
First Line	:	4149 E OXFORD LN
Second Line	:
City	:	HIGLEY
State	:	AZ
Zip	:	85236-3721
Country	:	US
Telephone Number	:	480-577-3808
Fax Number	:

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

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	01/10/2024

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