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1487627311

NPI Code Detail

MEDICARE: MR. DENNIS J WOODS CRNA

MEDICARE: MR. DENNIS J WOODS CRNA

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	367500000X	Certified Registered Nurse Anesthetist	R42887	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	430044194	OTHER	NM	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	10002374	OTHER	NM	LOVELACE HP
6	201018788	OTHER	NM	PRESBYTERIAN HP
7	NM006487	OTHER	NM	BCBS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487627311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DENNIS J WOODS CRNA

Provider Business Mailing Address
First Line	:	PO BOX 6210
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87499-6210
Country	:	US
Telephone Number	:	505-609-2258
Fax Number	:	505-609-2259

Provider Business Practice Location Address
First Line	:	801 W MAPLE ST
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87401-5630
Country	:	US
Telephone Number	:	505-609-6161
Fax Number	:	505-330-3865

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	07/21/2016

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Directions to “ MR. DENNIS J WOODS CRNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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