Provider Demographics
NPI:1447020698
Name:ATWOOD, IRENE (CHW)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:ATWOOD
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12251 JAMES ST STE 400
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-8943
Mailing Address - Country:US
Mailing Address - Phone:616-393-4439
Mailing Address - Fax:616-393-4435
Practice Address - Street 1:12251 JAMES ST STE 400
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8943
Practice Address - Country:US
Practice Address - Phone:616-393-4439
Practice Address - Fax:616-393-4435
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker