1043076086 NPI number — HEATHER NOELLE WOODS BSN, RN, IBCLC

Table of content: HEATHER NOELLE WOODS BSN, RN, IBCLC (NPI 1043076086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043076086 NPI number — HEATHER NOELLE WOODS BSN, RN, IBCLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOODS
Provider First Name:
HEATHER
Provider Middle Name:
NOELLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BSN, RN, IBCLC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WOODS
Provider Other First Name:
NOELLE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BSN, RN, IBCLC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1043076086
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
635 SCHOOL LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHRISTIANSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24073-2005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-449-6936
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
805 DAVIS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLACKSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24060-7013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-585-1985
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174N00000X , with the licence number:  L306771 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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