Healthcare Provider Details

I. General information

NPI: 1972415941
Provider Name (Legal Business Name): ASHLEY NICOLE WOODY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N CENTER ST
ASHLAND VA
23005-1532
US

IV. Provider business mailing address

4605 BATTLELINE DR
MECHANICSVILLE VA
23111-6968
US

V. Phone/Fax

Practice location:
  • Phone: 804-752-3041
  • Fax:
Mailing address:
  • Phone: 804-517-2063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001265768
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: