Healthcare Provider Details

I. General information

NPI: 1841165602
Provider Name (Legal Business Name): CARLI MARIE WOODLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E J AVE
GRUNDY CENTER IA
50638-2028
US

IV. Provider business mailing address

201 E J AVE
GRUNDY CENTER IA
50638-2028
US

V. Phone/Fax

Practice location:
  • Phone: 319-824-5421
  • Fax: 319-824-6291
Mailing address:
  • Phone: 319-824-5421
  • Fax: 319-824-6291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA187701
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: