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General NPI Number Information
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NPI Number | 1407588346
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Entity Type | Organization
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Legal Business Name | WOOD PRIMARY CARE CLINIC PLLC
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 2524 ALEXANDER DR STE D
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City | JONESBORO
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State | AR
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Zip | 72401-7175
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Country | US
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Telephone | 870-336-2232
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Fax | 870-336-2051
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Provider Business Mailing Address
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Address Line | 2524 ALEXANDER DR STE D
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City | JONESBORO
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State | AR
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Zip | 72401-7175
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Country | US
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Telephone | 870-919-2874
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Fax |
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | MS. JESSICA WOOD
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Credential | APRN
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Telephone | 870-919-2874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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