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General NPI Number Information
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NPI Number | 1356179329
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Entity Type | Individual
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Provider Name | CASEY WOODSON AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 1302 MEDICAL CENTER DR
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City | WILMINGTON
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State | NC
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Zip | 28401-7503
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Country | US
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Telephone | 910-343-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 MEDICAL CENTER DR
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City | WILMINGTON
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State | NC
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Zip | 28401-7503
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5020483
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 5020483
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License Number State | NC
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