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General NPI Number Information
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NPI Number | 1073930947
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Entity Type | Individual
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Provider Name | NATASHA CELEST WOODHAM APRN
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Gender | Female
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 1612 TENNESSEE AVE STE 300
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City | LYNN HAVEN
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State | FL
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Zip | 32444-3653
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Country | US
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Telephone | 850-872-0774
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Fax |
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Provider Business Mailing Address
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Address Line | 5819 FRANK HOUGH RD
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City | PANAMA CITY
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State | FL
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Zip | 32404-3062
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Country | US
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Telephone | 850-896-1285
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN9244792
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License Number State | FL
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