Individual
SAMANTHA J WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2104 LOOP RD STE C, WINNSBORO, LA 71295-3341
(318) 435-4571
Mailing address
PO BOX 1300, WINNSBORO, LA 71295-1300
(318) 435-9411
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
213748
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14953599
CAQH
—
05
—
2547798
—
LA
01
—
MEDICARE
1J3802
LA
Enumeration date
08/17/2020
Last updated
04/07/2021
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