Individual
MRS. BEVERLY LYNN WOODBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CNP
Contact information
Practice address
401 CARLSON PARKWAY, MINNETONKA, MN 55305-5387
(952) 992-3637
(952) 992-3039
Mailing address
7720 164TH LN NW, ANOKA, MN 55303-3560
(763) 753-4242
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
290710-23
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7632230900
—
MN
Enumeration date
01/16/2006
Last updated
01/23/2012
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