MEDICARE: MS. ANGELA L WOOD APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN 7899	TN

General Provider Information

NPI Number	:	1053387977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA L WOOD APN

Provider Business Mailing Address
First Line	:	1432 W MAIN ST
Second Line	:	SUITE 700
City	:	LEBANON
State	:	TN
Zip	:	37087-1323
Country	:	US
Telephone Number	:	615-444-1880
Fax Number	:	615-444-7411

Provider Business Practice Location Address
First Line	:	1432 W MAIN ST
Second Line	:	STE 700
City	:	LEBANON
State	:	TN
Zip	:	37087-1323
Country	:	US
Telephone Number	:	615-781-0013
Fax Number	:	615-781-0688

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	01/07/2022

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