Healthcare Provider Details

I. General information

NPI: 1780293027
Provider Name (Legal Business Name): CHRISTINA ANN WOODS PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA ANN NORTH-WOODS PMHNP-BC

II. Dates (important events)

Enumeration Date: 07/22/2020
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TRILLIUM WAY
CORBIN KY
40701-8426
US

IV. Provider business mailing address

1 TRILLIUM WAY
CORBIN KY
40701-8426
US

V. Phone/Fax

Practice location:
  • Phone: 606-528-1212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3014828
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: