Provider Demographics
NPI:1285243741
Name:WOODS, TERA RAE
Entity type:Individual
Prefix:
First Name:TERA
Middle Name:RAE
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 MAGNOLIA RD
Mailing Address - Street 2:
Mailing Address - City:FRENCH CREEK
Mailing Address - State:WV
Mailing Address - Zip Code:26218-2440
Mailing Address - Country:US
Mailing Address - Phone:681-533-8301
Mailing Address - Fax:
Practice Address - Street 1:1355 MAGNOLIA RD
Practice Address - Street 2:
Practice Address - City:FRENCH CREEK
Practice Address - State:WV
Practice Address - Zip Code:26218-2440
Practice Address - Country:US
Practice Address - Phone:681-533-8301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant