MEDICARE: MRS. COURTNEY WOOD

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	363LP0200X	Pediatric Nurse Practitioner	2026010965	MO

General Provider Information

NPI Number	:	1639026644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COURTNEY WOOD

Provider Business Mailing Address
First Line	:	1057 MEDICAL PARK DR BLDG 2
Second Line	:
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065-3000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1057 MEDICAL PARK DR BLDG 2
Second Line	:
City	:	OSAGE BEACH
State	:	MO
Zip	:	65065-3000
Country	:	US
Telephone Number	:	573-302-3100
Fax Number	:

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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Directions to “ MRS. COURTNEY WOOD ” Practice Location

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