Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | RN030377 | GA |
NPI | 1043252117 |
---|---|
Provider Name | Susan S Wood |
First Address | Savannah, GA 31406-3905 |
Second Address | Savannah, GA 31406-3905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 09/07/2007 |