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General NPI Number Information
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NPI Number | 1205484474
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Entity Type | Individual
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Provider Name | JENIFER ELIZABETH WOOD CPM
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Gender | Female
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 600 S MISSION RIDGE AVE APT 11
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City | COLBY
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State | KS
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Zip | 67701-3248
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Country | US
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Telephone | 785-443-4048
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Fax |
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Provider Business Mailing Address
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Address Line | 600 S MISSION RIDGE AVE APT 11
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City | COLBY
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State | KS
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Zip | 67701-3248
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Country | US
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Telephone | 785-443-4048
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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 | 19080020
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License Number State |
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