Mirannda Nicole Woodberry, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

5221742 Issued in FL

Practice address

1925 Waycrest Dr SW Apt 2201
Atlanta, GA 30331-8467

Phone

(850) 590-5187

NPI assigned

Dec 1, 2020

Last updated

Dec 1, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1538764428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 WAYCREST DR SW APT 2201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318467",
            "telephone_number": "850-590-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 WAYCREST DR SW APT 2201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318467",
            "telephone_number": "850-590-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODBERRY",
        "first_name": "MIRANNDA",
        "middle_name": "NICOLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "5221742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "0000000000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NotForgotten365staffing@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "1925 Waycrest Dr SW Apt 2201",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303318467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Evan Dane Woodard
• Kim Woodard, M.A., M.S., LPC
• Lawrence Woodard, M.D.
• Mikayla Woodard
• Todd Woodard, PHARMD
• Robin K. Woodberry, M.D., PHARM.D.
• Ryan Amorell Woodbury Martin, LCSW
• Anna Woodbury, M.D.
• Richard Woodcock
• Dayshea Alexis Wooden, NP

• Licensed Practical Nurse in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.