Healthcare Provider Details

I. General information

NPI: 1336136621
Provider Name (Legal Business Name): MICHELLE KATHRYN WOOD RN, CNS, LNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2005
Last Update Date: 05/08/2020
Certification Date: 05/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 N MAIN ST
HARRISONBURG VA
22802
US

IV. Provider business mailing address

1241 N MAIN ST
HARRISONBURG VA
22802-4632
US

V. Phone/Fax

Practice location:
  • Phone: 540-434-1941
  • Fax: 540-433-8277
Mailing address:
  • Phone: 540-434-1941
  • Fax: 540-433-8277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0017138329
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number0001143842
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: