Healthcare Provider Details

I. General information

NPI: 1265247159
Provider Name (Legal Business Name): CAROLYN JOANN WOODS BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 E. LINWOOD BLVD
KANSAS CITY MO
64128
US

IV. Provider business mailing address

15502 E 37TH TER S
INDEPENDENCE MO
64055-3627
US

V. Phone/Fax

Practice location:
  • Phone: 816-922-2641
  • Fax: 816-922-3342
Mailing address:
  • Phone: 816-210-4694
  • Fax: 816-922-3342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number2008021545
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: