Provider Demographics
NPI:1265103790
Name:WOODS, WINDI KAY (PMHNP)
Entity type:Individual
Prefix:DR
First Name:WINDI
Middle Name:KAY
Last Name:WOODS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11017 S VIA ENCANTADA WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-5623
Mailing Address - Country:US
Mailing Address - Phone:801-455-2442
Mailing Address - Fax:
Practice Address - Street 1:1875 SOUTH REDWOOD ROAD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84104-1727
Practice Address - Country:US
Practice Address - Phone:801-355-2846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT289027-4405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health