Individual
KIMBERLY D WOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
262 DANNY THOMAS PL, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Mailing address
262 DANNY THOMAS PL, MS 515, MEMPHIS, TN 38105-3678
(901) 595-3006
(901) 595-3842
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
13440
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
13440
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376710889
—
AL
05
—
1508062
—
TN
Enumeration date
05/14/2008
Last updated
10/02/2012
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