Healthcare Provider Details

I. General information

NPI: 1558773572
Provider Name (Legal Business Name): PRECISSE WOODS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PRECISSE WOODS AGNP-C

II. Dates (important events)

Enumeration Date: 05/26/2014
Last Update Date: 05/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 OAK TREE BLVD PARK CENTER PLAZA II
INDEPENDENCE OH
44131-6917
US

IV. Provider business mailing address

3942 CAMELIA GLEN LN
FRESNO TX
77545-8762
US

V. Phone/Fax

Practice location:
  • Phone: 216-518-1025
  • Fax:
Mailing address:
  • Phone: 713-894-2472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP125424
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP125424
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: