Provider Demographics
NPI:1316600059
Name:WOODS, SIERRA (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6123 PILLORY DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-5057
Mailing Address - Country:US
Mailing Address - Phone:317-430-5287
Mailing Address - Fax:
Practice Address - Street 1:6123 PILLORY DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5057
Practice Address - Country:US
Practice Address - Phone:317-430-5287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28256016A163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant