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General NPI Number Information
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NPI Number | 1316850993
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Entity Type | Individual
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Provider Name | NERISSA WOOD
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Gender | Female
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 1906 BLAKE AVE
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-4259
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Country | US
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Telephone | 970-384-7579
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Fax |
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Provider Business Mailing Address
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Address Line | 585 GORDON AVE
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City | HARAHAN
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State | LA
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Zip | 70123-3943
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Country | US
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Telephone | 970-384-7579
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 086310
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License Number State | LA
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