Healthcare Provider Details

I. General information

NPI: 1891771929
Provider Name (Legal Business Name): ARLENE A. WOODS RN, BC, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARLENE A. HANSON

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 06/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE MADRONE ST
WILLITS CA
95490
US

IV. Provider business mailing address

ONE MADRONE ST
WILLITS CA
95490
US

V. Phone/Fax

Practice location:
  • Phone: 707-459-6801
  • Fax:
Mailing address:
  • Phone: 707-459-6801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number829386
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: