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General NPI Number Information
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NPI Number | 1194010769
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Entity Type | Individual
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Provider Name | JANEEN JENSEN WOOD NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/12/2011
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 1008 LAKE MURRAY BLVD
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City | IRMO
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State | SC
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Zip | 29063-2821
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Country | US
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Telephone | 803-749-3840
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Fax |
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Provider Business Mailing Address
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Address Line | 233 RIVER CREEK DR
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City | IRMO
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State | SC
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Zip | 29063-8301
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Country | US
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Telephone | 803-318-8346
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Fax | 803-400-3569
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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 | 17985
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F0511082
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License Number State | TX
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