Provider Demographics
NPI:1982394185
Name:WOODS, NICOLE
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:HORTON
Mailing Address - State:MI
Mailing Address - Zip Code:49246-0065
Mailing Address - Country:US
Mailing Address - Phone:517-936-8792
Mailing Address - Fax:
Practice Address - Street 1:7523 FOWLER RD
Practice Address - Street 2:
Practice Address - City:HORTON
Practice Address - State:MI
Practice Address - Zip Code:49246-9580
Practice Address - Country:US
Practice Address - Phone:517-936-8792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula