Provider Demographics
NPI:1588381701
Name:WOODS, HANEEFAH SHAFEEQUAH (RN, NP)
Entity type:Individual
Prefix:MRS
First Name:HANEEFAH
Middle Name:SHAFEEQUAH
Last Name:WOODS
Suffix:
Gender:
Credentials:RN, NP
Other - Prefix:MRS
Other - First Name:HANEEFAH
Other - Middle Name:SHAFEEQUAH
Other - Last Name:TUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:600 WESTRIDGE PKWY STE 714
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-7789
Mailing Address - Country:US
Mailing Address - Phone:409-519-9480
Mailing Address - Fax:
Practice Address - Street 1:600 WESTRIDGE PKWY STE 714
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-7789
Practice Address - Country:US
Practice Address - Phone:409-519-9480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029552363LF0000X, 363LP0808X
GAGAA-NP001833363LP0808X, 363LF0000X
FLRN9485289163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty