=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821725334
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATALIE DIANE WOOD NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2022
-----------------------------------------------------
Last Update Date | 08/04/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 618 HOSPITAL RD
-----------------------------------------------------
City | TAPPAHANNOCK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22560-5000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-518-6681
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3368 NEW HERITAGE LOOP
-----------------------------------------------------
City | HENRICO
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23231-5144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-518-6681
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | 0024183786
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------