Healthcare Provider Details

I. General information

NPI: 1396827937
Provider Name (Legal Business Name): TERRENCE ELIZABETH WOOD RN/CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 NICOLLET MALL SUITE 400
MINNEAPOLIS MN
55402-2500
US

IV. Provider business mailing address

801 NICOLLET MALL SUITE 400
MINNEAPOLIS MN
55402-2500
US

V. Phone/Fax

Practice location:
  • Phone: 612-333-2503
  • Fax:
Mailing address:
  • Phone: 612-333-2503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0998060
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: