Individual
MRS. ANGELA MARIE WOODRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8601 CHARENTE WAY, ELK GROVE, CA 95758-7028
(623) 399-9996
Mailing address
8601 CHARENTE WAY, ELK GROVE, CA 95758-7028
(623) 399-9996
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
840059
CA
163WP0200X
Pediatric Registered Nurse
840059
CA
261QM3000X
Medically Fragile Infants and Children Day Care
840059
CA
Other
Enumeration date
04/28/2015
Last updated
04/28/2015
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