Provider Demographics
NPI:1891898151
Name:WOODARD, DELORES A (ARNP)
Entity type:Individual
Prefix:
First Name:DELORES
Middle Name:A
Last Name:WOODARD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:4070 DELP MS 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-6200
Mailing Address - Fax:913-588-6271
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:OBGYN DEPT MS 2028
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6200
Practice Address - Fax:913-588-6271
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-66773-121163W00000X
KS45258363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
448000OtherFIRSTGUARD
KS073B474AMedicare ID - Type Unspecified
P46723Medicare UPIN