MEDICARE: CAMILLE L WOODS 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
1	363LA2200X	Adult Health Nurse Practitioner	RN062815	AZ
2	363LF0000X	Family Nurse Practitioner	0614	AZ

General Provider Information

NPI Number	:	1275596371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMILLE L WOODS NP

Provider Business Mailing Address
First Line	:	3003 N CENTRAL AVE
Second Line	:	STE 800
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2902
Country	:	US
Telephone Number	:	602-462-1132
Fax Number	:	602-462-1186

Provider Business Practice Location Address
First Line	:	3003 N CENTRAL AVE
Second Line	:	STE 800
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2902
Country	:	US
Telephone Number	:	602-462-1132
Fax Number	:	602-462-1186

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

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	07/24/2015

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