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General NPI Number Information
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NPI Number | 1104947993
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Entity Type | Individual
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Provider Name | LINDA A WOODSON
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Gender | Female
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 121 SQUIRREL TRAIL
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City | REIDSVILLE
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State | NC
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Zip | 27320
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Country | US
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Telephone | 336-349-2585
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Fax | 336-349-3174
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Provider Business Mailing Address
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Address Line | 476 NC HIGHWAY 87
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City | REIDSVILLE
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State | NC
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Zip | 27320-9724
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Country | US
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Telephone | 336-349-2585
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Fax | 336-349-3174
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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 | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | FCL079016
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License Number State | NC
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