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General NPI Number Information
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NPI Number | 1023377009
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Entity Type | Individual
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Provider Name | JOHN W WOODELL CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 05/10/2012
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Provider Practice Location Address
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Address Line | 4200 N RODNEY PARHAM RD NO 203
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City | LITTLE ROCK
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State | AR
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Zip | 72212-2461
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Country | US
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Telephone | 615-620-2320
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Fax | 615-620-2323
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Provider Business Mailing Address
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Address Line | PO BOX 291264
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City | NASHVILLE
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State | TN
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Zip | 37229-1264
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Country | US
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Telephone | 615-620-2320
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Fax | 615-620-2323
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | C02896
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License Number State | AR
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