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General NPI Number Information
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NPI Number | 1386154391
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Entity Type | Individual
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Provider Name | MICHELLE PATRICIA WOOD NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/04/2017
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 10000 TELEGRAPH RD
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City | TAYLOR
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State | MI
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Zip | 48180-3330
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Country | US
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Telephone | 313-295-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 22220 AUDETTE ST
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City | DEARBORN
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State | MI
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Zip | 48124-4703
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Country | US
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Telephone | 313-623-9098
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 4704278104
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License Number State | MI
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