Provider Demographics
NPI:1447469713
Name:WOODYARD, DIANE KAY (RN)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:KAY
Last Name:WOODYARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 CANARY LN
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16116-6415
Mailing Address - Country:US
Mailing Address - Phone:724-071-2795
Mailing Address - Fax:
Practice Address - Street 1:217 CANARY LN
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:PA
Practice Address - Zip Code:16116-6415
Practice Address - Country:US
Practice Address - Phone:724-071-2795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN347998L163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice