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Elisha Dowdy Woods

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1101 S 28th Ave Ste B, Hattiesburg, MS 39402-2610

PECOS Enrollment

Based on the most recent information from CMS, provider Elisha Dowdy Woods does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1659675064
Provider Type
Individual
Full Name
Woods, Elisha Dowdy
Credential
FNP

Gender
Female
Sole Proprietor
No
Enumeration Date
12/28/2010
Last Updated
6/2/2021

Contact Information

Practice Location

1101 S 28th Ave Ste B, Hattiesburg, MS 39402-2610

(601) 296-2990

(601) 296-2860

Mailing Location

415 S 28th Ave, Hattiesburg, MS 39401-7246

(601) 296-2990

(601) 579-5240

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 873696 Mississippi
Code 363L00000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License R873696 Mississippi

Provider Identifiers

ID	Description	Issuer
ID 02003530	Description Medicaid	Issuer Unlisted Mississippi
ID 9686623	Description Other	Issuer AETNA Mississippi

Elisha Dowdy Woods

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Pattie, Jennifer Farris

Dawson, Cynthia

Pou, Lindsi

Marsh, John E.

Roberts, Erin Kathleen

Nicholas, Jill

Brumfield, Shermanda M

Heidelburg, Tavithia

Hudson, Thomas Neil

Loustalot, Fleetwood