Chanetta Lashan Woodham, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-098137 Issued in AL

Practice address

207 Haven Dr
Dothan, AL 36301-2919

Phone

(334) 793-3319

Fax

(334) 793-2291

NPI assigned

Jun 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Chanetta Lashan Payton Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1619264520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 S BRANNON STAND RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363057367",
            "telephone_number": "334-714-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HAVEN DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012919",
            "telephone_number": "334-793-3319",
            "fax_number": "334-793-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODHAM",
        "first_name": "CHANETTA",
        "middle_name": "LASHAN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-098137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANETTA",
            "last_name": "PAYTON",
            "middle_name": "LASHAN",
            "prefix": "MS.",
            "credential": "CRNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Emily Wood, RBT
• Kari Ross Wood, CRNP
• Meredith Wood
• Timothy Marvin Woodall, CRNA
• James Woodcox, LICSW, ADC
• Cynthia Lynn Woodham, FNP
• David Bruce Woodham, MD
• Jill D Woodham, CRNP
• Regan Woodham, AGACNP-BC
• Laura Wool, LPC

• Family Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.