Healthcare Provider Details

I. General information

NPI: 1396293742
Provider Name (Legal Business Name): JANELLE WOOD APRN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EMILE 42ND ST
OMAHA NE
68198-0001
US

IV. Provider business mailing address

988102 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8102
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-6195
  • Fax: 402-559-9586
Mailing address:
  • Phone: 402-559-6195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number112116
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number112116
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: