Healthcare Provider Details

I. General information

NPI: 1154246759
Provider Name (Legal Business Name): MRS. SANDY MARIE WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 COLLEGE ST
BALDWIN CITY KS
66006-4041
US

IV. Provider business mailing address

1817 COLLEGE ST
BALDWIN CITY KS
66006-4041
US

V. Phone/Fax

Practice location:
  • Phone: 785-333-4326
  • Fax:
Mailing address:
  • Phone: 785-333-4326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberG023015
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: