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General NPI Number Information
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NPI Number | 1134226269
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Entity Type | Individual
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Provider Name | TINA MARIE WOODBY CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 04/11/2016
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Provider Practice Location Address
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Address Line | 801 E 6TH ST SUITE 205 GULF COAST REGIONAL MEDICAL CENTER
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City | PANAMA CITY
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State | FL
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Zip | 32405
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Country | US
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Telephone | 850-769-8341
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Fax | 954-851-1746
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Provider Business Mailing Address
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Address Line | 1613 NORTH HARRISON PARKWAY SUITE 200, MAILSTOP SH 9
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City | SUNRISE
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State | FL
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Zip | 33323
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Country | US
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Telephone | 954-838-2371
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Fax | 954-616-3879
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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 | ARNP3027672
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License Number State | FL
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