Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 17447 | CA |
Y | 363LC1500X | Nurse Practitioner - Community Health | APRN001647 | NV |
NPI | 1205021474 |
---|---|
Provider Name | Ms. Minnie Elizabeth Wood |
First Address | Las Vegas, NV 89104-1046 |
Second Address | Las Vegas, NV 89104-1046 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2007 |
Last Update Date | 07/09/2017 |