MEDICARE: MRS. APRIL CHARLENE WOOD LPN

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	164W00000X	Licensed Practical Nurse	251907-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841454097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. APRIL CHARLENE WOOD LPN

Provider Business Mailing Address
First Line	:	195 MC GOWAN RD
Second Line	:
City	:	NORTH BANGOR
State	:	NY
Zip	:	12966-1811
Country	:	US
Telephone Number	:	518-483-8282
Fax Number	:

Provider Business Practice Location Address
First Line	:	195 MCGOWAN RD
Second Line	:
City	:	NORTH BANGOR
State	:	NY
Zip	:	12966-0000
Country	:	US
Telephone Number	:	518-483-8289
Fax Number	:

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

Provider Enumeration Date	:	07/17/2008
Last Update Date	:	07/17/2008

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