Provider Demographics
NPI:1083198170
Name:WOOD, EKATERINA (FNP-C)
Entity Type:Individual
Prefix:
First Name:EKATERINA
Middle Name:
Last Name:WOOD
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 1:101 PROVIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-6155
Mailing Address - Country:US
Mailing Address - Phone:540-535-8658
Mailing Address - Fax:
Practice Address - Street 1:160 WARRIOR DR
Practice Address - Street 2:
Practice Address - City:STEPHENS CITY
Practice Address - State:VA
Practice Address - Zip Code:22655
Practice Address - Country:US
Practice Address - Phone:540-868-4100
Practice Address - Fax:540-868-0888
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176647363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner