Provider Demographics
NPI:1427652841
Name:WOODS, CUSHENA SHRONDA (LPN)
Entity type:Individual
Prefix:
First Name:CUSHENA
Middle Name:SHRONDA
Last Name:WOODS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10922 SCHUETZ RD # 6
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5704
Mailing Address - Country:US
Mailing Address - Phone:314-922-9148
Mailing Address - Fax:
Practice Address - Street 1:10922 SCHUETZ RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5704
Practice Address - Country:US
Practice Address - Phone:314-922-9148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017004939164W00000X
MO374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No164W00000XNursing Service ProvidersLicensed Practical Nurse