Provider Demographics
NPI:1902792559
Name:WOUND-1 MOBILE CERTIFIED WOUND EXPERTS
Entity type:Organization
Organization Name:WOUND-1 MOBILE CERTIFIED WOUND EXPERTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIGRID
Authorized Official - Middle Name:CHANTELLE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-333-1863
Mailing Address - Street 1:814 14TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-1028
Mailing Address - Country:US
Mailing Address - Phone:833-968-8881
Mailing Address - Fax:
Practice Address - Street 1:4760 S PECOS RD STE 200015
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-6038
Practice Address - Country:US
Practice Address - Phone:209-486-7779
Practice Address - Fax:209-554-7911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty