Healthcare Provider Details

I. General information

NPI: 1598462012
Provider Name (Legal Business Name): JENNIFER CHRISTINE WOODY AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 GREEN VALLEY RD STE 101
GREENSBORO NC
27408-7022
US

IV. Provider business mailing address

542 WHITE OAK ST
ASHEBORO NC
27203-4772
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-3600
  • Fax: 336-890-4467
Mailing address:
  • Phone: 336-451-9071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5018436
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number209699
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAG06230049
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: