Individual
TINA SUE WOODCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9804 BROWNSVILLE RD, MORGANTOWN, KY 42261-9030
(270) 999-5801
Mailing address
9804 BROWNSVILLE RD, MORGANTOWN, KY 42261-9030
(270) 999-5801
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1109033
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3007395
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100233350
—
KY
Enumeration date
05/02/2012
Last updated
04/09/2013
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