Provider Demographics
NPI:1700987427
Name:WOODARD, TAMMY (OGNP)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:
Last Name:WOODARD
Suffix:
Gender:F
Credentials:OGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4016
Mailing Address - Country:US
Mailing Address - Phone:919-934-3015
Mailing Address - Fax:919-934-0958
Practice Address - Street 1:520 NORTH ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4016
Practice Address - Country:US
Practice Address - Phone:919-934-3015
Practice Address - Fax:919-934-0958
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC800150363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology