Healthcare Provider Details

I. General information

NPI: 1376494898
Provider Name (Legal Business Name): CHRISTIAN WOODS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 S MULBERRY ST
LOGAN OH
43138-1240
US

IV. Provider business mailing address

1129 BRIDGEMAN ST
SYRACUSE OH
45779-5208
US

V. Phone/Fax

Practice location:
  • Phone: 740-270-3286
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number180154
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number180154
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: