PHYLLIS KELLY WOOD (NPI# 1548872468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548872468 |
| Entity Type | Individual |
| Full Name | PHYLLIS KELLY WOOD |
| Practice Address |
217 Banks Rd Suite 31 Fayetteville GA 30214 |
| Mailing Address |
736 Bieze St Griffin GA 30224-5004 |
| Practice Telephone | 4049032146 |
| Mailing Telephone | 6785886086 |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2020-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN216745 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN216745 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588875546 | Phyllis Raye Wood | Counselor | 3004 Interurban Dr, Bartlesville, OK 74006-1403 | 2007-05-24 |
| 1881795854 | Phyllis L Wood | Nurse Practitioner | 1500 S Main St, Fort Worth, TX 76104-4917 | 2006-09-25 |
| Street Address |
217 BANKS RD SUITE 31 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| 1104303809 | St. Christophers Private Homecare Agency | Home Health | 110 Habersham Dr Ste 117, Fayetteville, GA 30214 | 2018-07-25 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932749561 | Jennifer Breathitt | Nurse Practitioner | 4542 W Wedge Dr, Fayetteville, AR 72704-7532 | 2020-01-11 |
| 1124666482 | Martha Lynn Brawner | Nurse Practitioner | 2882 N Bermuda Ave, Fayetteville, AR 72704-6034 | 2019-12-18 |
| 1437614013 | Michelle N Holder | Nurse Practitioner | 249 Otter Cir, Fayetteville, GA 30215-5264 | 2019-02-07 |
| 1730684960 | Kasondra Mcdonald | Nurse Practitioner | 117 Chadwick Farms Dr, Fayetteville, TN 37334-6081 | 2018-03-29 |
| 1265985931 | Stephanie R Rives | Nurse Practitioner | 18 Ivy Dr, Fayetteville, TN 37334-7287 | 2016-07-29 |
| 1538413646 | Joseph Patrick Madelone | Nurse Practitioner | 202 Cleveland Blvd, Fayetteville, NY 13066-1104 | 2012-10-29 |
| 1063048817 | Kenita Davis | Nurse Practitioner | 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 | 2020-03-12 |
| 1780218206 | Tara Howerton | Nurse Practitioner | 3276 N Northhills Blvd, Fayetteville, AR 72703-4005 | 2020-02-24 |
| 1861025173 | Laura Droke | Nurse Practitioner | 3211 N Northhills Blvd, Fayetteville, AR 72703-4007 | 2020-02-14 |
| 1063043578 | Lori Atchley Mitchell | Nurse Practitioner | 106 Medical Center Blvd, Fayetteville, TN 37334-2684 | 2020-02-03 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on PHYLLIS KELLY WOOD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.