Provider Demographics
NPI:1023746633
Name:WOOD, HOPE MANCINI (CRNA)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:MANCINI
Last Name:WOOD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:HOPE
Other - Middle Name:MARIE
Other - Last Name:MANCINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:11510 ELIZABETH MADISON CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-6107
Mailing Address - Country:US
Mailing Address - Phone:703-431-5317
Mailing Address - Fax:
Practice Address - Street 1:1000 HEALING WAY
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-4969
Practice Address - Country:US
Practice Address - Phone:800-821-1535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA136274367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered