Basic Information
| Provider Information | |||||||||
| NPI: | 1396827937 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOOD | ||||||||
| FirstName: | TERRENCE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | RN/CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 NICOLLET MALL | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554022500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123332503 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 801 NICOLLET MALL | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554022500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123332503 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 363LX0001X | 0998060 | MN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 2118418 | 01 | MN | AMERICA'S PPO | OTHER | 338S2WO | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | 0700065 | 01 | MN | MEDICA DUAL/MEDICARE MA | OTHER | 0109624 | 01 | MN | MEDICA CHOICE | OTHER | FP9041032028 | 01 | MN | PREFERRED ONE | OTHER | HP35775 | 01 | MN | HEALTH PARTNERS | OTHER |