MEDICARE: MRS. ANNE WOODLING CNP

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	363L00000X	Nurse Practitioner	CNP00925	NM
2	363L00000X	Nurse Practitioner	R41289	NM
3	207N00000X	Dermatology Physician	R41289	NM

General Provider Information

NPI Number	:	1790897957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNE WOODLING CNP

Provider Business Mailing Address
First Line	:	7300 RANCH ROAD 2222, BLDG 1, STE 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78730-3255
Country	:	US
Telephone Number	:	512-759-8932
Fax Number	:	512-233-2711

Provider Business Practice Location Address
First Line	:	141 N ROADRUNNER PKWY STE 228
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-2001
Country	:	US
Telephone Number	:	575-521-1177
Fax Number	:	575-449-4963

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/16/2023

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