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General NPI Number Information
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NPI Number | 1811436744
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Entity Type | Individual
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Provider Name | DASHARDRA WOODARD FNP
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Gender | Female
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Dates
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Enumeration Date | 02/12/2017
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 1251 WESLEY DR STE 104
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City | MEMPHIS
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State | TN
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Zip | 38116-6442
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Country | US
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Telephone | 901-310-4916
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Fax | 901-425-9586
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Provider Business Mailing Address
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Address Line | 5164 DURANT ST
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City | MEMPHIS
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State | TN
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Zip | 38116-8310
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Country | US
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Telephone | 901-337-1371
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 55181
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 342193
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0001213-C
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 903290
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP133236
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95005888
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 21990
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License Number State | TN
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