Provider Demographics
NPI:1053387977
Name:WOOD, ANGELA L (APN)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:L
Last Name:WOOD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1432 W MAIN ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-1323
Mailing Address - Country:US
Mailing Address - Phone:615-444-1880
Mailing Address - Fax:615-444-7411
Practice Address - Street 1:1432 W MAIN ST
Practice Address - Street 2:STE 700
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1323
Practice Address - Country:US
Practice Address - Phone:615-781-0013
Practice Address - Fax:615-781-0688
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN 7899363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP52706Medicare UPIN
TN3348154Medicare ID - Type Unspecified