Healthcare Provider Details

I. General information

NPI: 1326156811
Provider Name (Legal Business Name): CYNTHIA GILLILAND WOODARD CNS,,COCN,MSN,MED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FREEDOM WAY
AUGUSTA GA
30904-6258
US

IV. Provider business mailing address

2618 WALTON WAY
AUGUSTA GA
30904-4650
US

V. Phone/Fax

Practice location:
  • Phone: 706-733-0188
  • Fax: 706-823-3939
Mailing address:
  • Phone: 706-738-5160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberRN048397
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: