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General NPI Number Information
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NPI Number | 1245575042
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Entity Type | Individual
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Provider Name | TRACY C WOODS NP
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Gender | Female
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 6300 W 95TH ST HEARTLAND CARE PARTNERS
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City | OAK LAWN
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State | IL
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Zip | 60453-2256
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Country | US
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Telephone | 800-375-5495
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Fax | 800-564-5952
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Provider Business Mailing Address
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Address Line | 3450 W CENTRAL AVE STE 230 HCR MANORCARE MEDICAL SERVICES OF FLORIDA, LLC
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City | TOLEDO
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State | OH
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Zip | 43606-1417
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Country | US
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Telephone | 800-375-5495
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Fax | 800-564-5952
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209009993
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License Number State | ID
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