Healthcare Provider Details

I. General information

NPI: 1922192855
Provider Name (Legal Business Name): CARLA B WOODARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 ALCOA HWY UT INTERNAL MEDICINE & OB/GYN CENTER
KNOXVILLE TN
37920-1511
US

IV. Provider business mailing address

1924 ALCOA HWY UT INTERNAL MEDICINE & OB/GYN CENTER
KNOXVILLE TN
37920-1511
US

V. Phone/Fax

Practice location:
  • Phone: 865-544-8787
  • Fax: 865-544-8260
Mailing address:
  • Phone: 865-544-8787
  • Fax: 865-544-8260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number5230
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: