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General NPI Number Information
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NPI Number | 1093221582
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Entity Type | Individual
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Provider Name | REGINA NICOLE WOODLEY IBCLC
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Gender | Female
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 7540 MEMORIAL PARKWAY SUITE H
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City | HUNTSVILLE
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State | AL
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Zip | 35802
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Country | US
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Telephone | 325-939-4141
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Fax | 256-484-5536
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Provider Business Mailing Address
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Address Line | 18310 EDGEWOOD RD
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City | ATHENS
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State | AL
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Zip | 35614-6028
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Country | US
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Telephone | 325-939-4141
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 22020004
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License Number State | AL
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