Provider Demographics
NPI:1316248453
Name:EXUM-WOODS, MICHELLE R
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:R
Last Name:EXUM-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 1:493 WATERFORD DR
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-6457
Mailing Address - Country:US
Mailing Address - Phone:404-992-4031
Mailing Address - Fax:
Practice Address - Street 1:493 WATERFORD DR
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-6457
Practice Address - Country:US
Practice Address - Phone:404-992-4031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372500000X, 376J00000X, 376K00000X
GARN 188675372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide