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NPI Code Detail

MEDICARE: MS. MINNIE ELIZABETH WOOD NP

MEDICARE: MS. MINNIE ELIZABETH WOOD NP
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
1163W00000XRegistered Nurse661205CA
2363L00000XNurse Practitioner17447CA
3363LC1500XCommunity Health Nurse PractitionerAPRN001647NV

General Provider Information

NPI Number : 1205021474
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MINNIE ELIZABETH WOOD NP
Provider Business Mailing Address
First Line : 1200 S 4TH ST STE 111
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-1046
Country : US
Telephone Number : 702-380-8118
Fax Number : 702-380-2929
Provider Business Practice Location Address
First Line : 1200 S 4TH ST STE 111
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-1046
Country : US
Telephone Number : 702-380-8118
Fax Number : 702-380-2929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2007
Last Update Date : 07/21/2022

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Directions to “ MS. MINNIE ELIZABETH WOOD NP” Practice Location

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