Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 0101053151 | VA |
NPI | 1134238405 |
---|---|
Provider Name | Laura Lee Woodard |
First Address | Virginia Beach, VA 23462-3869 |
Second Address | Chesapeake, VA 23320-4941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 22/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
063YM | BLUE CROSS BLUE SHIELD NC (01) | NC |
082480 | BLUE CROSS BLUE SHIELD VA (01) | VA |
251490 | MAMSI/MDIPA (01) | |
27949 | OPTIMA (01) | |
3900570 | OPTIMUM CHOICE (01) | |
5847320 | (05) | VA |
89063YM | (05) | NC |
930088666 | MEDICARE RAILROAD (01) | |
G01037 | (02) |