Individual
CHARMAINE WOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-8623
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
(706) 721-8623
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN255135
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/12/2022
Last updated
10/19/2022
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