Basic Information
| Provider Information | |||||||||
| NPI: | 1942334008 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOODRICK | ||||||||
| FirstName: | TONI | ||||||||
| MiddleName: | FULLER | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RC, CNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1119 XANTHIA ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802203510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204798532 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 793 OLIVE ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802205552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033944386 | ||||||||
| FaxNumber: | 3033360966 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| 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 | 376K00000X | 174458 | CO | Y | Nursing Service Related Providers | Nurse's Aide |
No ID Information.