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General NPI Number Information
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NPI Number | 1790787315
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Entity Type | Individual
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Provider Name | WYETHA S WOOD ARNP, BC, MSN
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Gender | Female
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 04/30/2014
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Provider Practice Location Address
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Address Line | 310 HAWTHORNE ST
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City | PRINCETON
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State | KY
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Zip | 42445-1622
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Country | US
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Telephone | 270-365-0227
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Fax | 270-365-2559
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Provider Business Mailing Address
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Address Line | PO BOX 4156
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City | HOPKINSVILLE
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State | KY
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Zip | 42241-4156
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Country | US
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Telephone | 270-886-2205
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Fax | 270-886-0392
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2152P
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License Number State | KY
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