Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | E-6687 | AR |
NPI | 1144462383 |
---|---|
Provider Name | Shayna Marie Wood |
First Address | Little Rock, AR 72205-7202 |
Second Address | Little Rock, AR 72205-7202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 15/09/2015 |