Basic Information
| Provider Information | |||||||||
| NPI: | 1326357013 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOODS | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | TRENISE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7700 2ND AVE | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482022411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3132028500 | ||||||||
| FaxNumber: | 3132028653 | ||||||||
| Practice Location | |||||||||
| Address1: | 2888 W. GRAND BLVD. | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483263528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3138754200 | ||||||||
| FaxNumber: | 3138755727 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2010 | ||||||||
| LastUpdateDate: | 04/19/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 4704225061 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.