Healthcare Provider Details

I. General information

NPI: 1508241902
Provider Name (Legal Business Name): MONICA WOOD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2015
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 N 3RD ST STE 2015
PHOENIX AZ
85020-2404
US

IV. Provider business mailing address

PO BOX 945395
ATLANTA GA
30394-5395
US

V. Phone/Fax

Practice location:
  • Phone: 602-786-0030
  • Fax: 919-873-9821
Mailing address:
  • Phone: 888-280-9533
  • Fax: 919-873-9821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20368
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number275379
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number294437
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20368
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number275379
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: