Healthcare Provider Details

I. General information

NPI: 1174213425
Provider Name (Legal Business Name): DEANA WOOD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 N 3RD AVE STE 470
PHOENIX AZ
85013-4434
US

IV. Provider business mailing address

240 W THOMAS RD STE 301
PHOENIX AZ
85013-4407
US

V. Phone/Fax

Practice location:
  • Phone: 602-406-6262
  • Fax: 602-406-6261
Mailing address:
  • Phone: 602-406-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number334387
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number161881
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: