Provider Demographics
NPI:1053087031
Name:WOODS, KATIE SUE (FNP-C)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:SUE
Last Name:WOODS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 VON RUCK RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-3340
Mailing Address - Country:US
Mailing Address - Phone:804-210-7898
Mailing Address - Fax:
Practice Address - Street 1:450 PINEY FOREST RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4011
Practice Address - Country:US
Practice Address - Phone:434-799-1565
Practice Address - Fax:434-792-1405
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013165207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine