=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952326266
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NISHA MARIE WOODS MS, WHCNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2006
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3265 HILLCREST PARK DR
-----------------------------------------------------
City | MEDFORD
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97504-7657
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-275-6655
-----------------------------------------------------
Fax | 541-494-0945
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3156 STATE ST
-----------------------------------------------------
City | MEDFORD
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97504-8450
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 541-773-9772
-----------------------------------------------------
Fax | 541-773-1113
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 86006299
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------