Individual
TINA MARIE WOODROME-NETHERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2205 GREENTREE N, CLARKSVILLE, IN 47129
(812) 283-4441
(812) 288-2605
Mailing address
6801 DIXIE HWY, SUITE 130, LOUISVILLE, KY 40258-3913
(502) 543-4119
(502) 543-1462
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1105062
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201213260
—
IN
01
—
IN2570016
MEDICARE
IN
Enumeration date
08/07/2012
Last updated
06/04/2018
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