Provider Demographics
NPI:1346779220
Name:WOODRING, SANDRA ANN (CR-NP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:ANN
Last Name:WOODRING
Suffix:
Gender:F
Credentials:CR-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 DUFFY CT
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2554
Mailing Address - Country:US
Mailing Address - Phone:410-877-7650
Mailing Address - Fax:
Practice Address - Street 1:3300 N CALVERT ST STE 107
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2820
Practice Address - Country:US
Practice Address - Phone:410-554-6505
Practice Address - Fax:410-554-6788
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR135260363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner