Individual
JENNIFER MARIE WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(800) 374-5326
Mailing address
PO BOX 356, WICHITA, KS 67201-0356
(800) 374-5326
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1393982012
KS
367500000X
Certified Registered Nurse Anesthetist
139607
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
556903
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200624190A
—
KS
01
—
P00813786
RR MEDICARE GROUP CQ2302
KS
Enumeration date
06/11/2009
Last updated
05/18/2010
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