Individual
TARA WOODALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 MAVERICK CT, GRANBURY, TX 76049-1381
(888) 731-8994
Mailing address
112 MAVERICK CT, GRANBURY, TX 76049-1381
(888) 731-8994
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
160860
GA
Other
Enumeration date
02/25/2015
Last updated
10/18/2024
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