Provider Demographics
NPI:1447299946
Name:WOODY, MARIANNE O (CRNP)
Entity type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:O
Last Name:WOODY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 WOODMONT DR
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632-8939
Mailing Address - Country:US
Mailing Address - Phone:412-445-9220
Mailing Address - Fax:412-809-6885
Practice Address - Street 1:2730 UNIVERSITY BLVD W STE 400
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-1972
Practice Address - Country:US
Practice Address - Phone:443-351-3376
Practice Address - Fax:301-933-0960
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP005136B363L00000X
MDR266323363L00000X
NYF335201-01363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11391728OtherCAQH
PAPENDINGMedicaid