Healthcare Provider Details

I. General information

NPI: 1437337490
Provider Name (Legal Business Name): LINDA LOU ZUREK WOOD CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6633 RED ARROW HWY
COLOMA MI
49038-8717
US

IV. Provider business mailing address

6633 RED ARROW HWY
COLOMA MI
49038-8717
US

V. Phone/Fax

Practice location:
  • Phone: 269-468-7684
  • Fax: 269-468-7687
Mailing address:
  • Phone: 269-468-7684
  • Fax: 269-468-7687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704124367
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704124367
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: