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NPI Code Detail

MEDICARE: MRS. HOLLY ELIZABETH WOOD

MEDICARE: MRS. HOLLY ELIZABETH 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
1390200000XStudent in an Organized Health Care Education/Training Program
2367500000XCertified Registered Nurse Anesthetist8063NC

General Provider Information

NPI Number : 1770214421
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HOLLY ELIZABETH WOOD
Provider Business Mailing Address
First Line : 100 KIMEL FOREST DR
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-6074
Country : US
Telephone Number : 336-716-2255
Fax Number :
Provider Business Practice Location Address
First Line : 124 E GATE CITY BLVD
Second Line :
City : GREENSBORO
State : NC
Zip : 27406-1457
Country : US
Telephone Number : 209-321-5858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2022
Last Update Date : 03/04/2026

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Directions to “ MRS. HOLLY ELIZABETH WOOD ” Practice Location

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