Provider Demographics
NPI:1164431987
Name:WOOD, KAREN MARIE (ANP)
Entity Type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:MARIE
Last Name:WOOD
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:PAPPENFUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8502 BRANDING IRON CT
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20171
Mailing Address - Country:US
Mailing Address - Phone:703-318-3265
Mailing Address - Fax:
Practice Address - Street 1:11975 BOWMAN TOWNE DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3306
Practice Address - Country:US
Practice Address - Phone:571-323-1417
Practice Address - Fax:703-437-1975
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017000240363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAS45189Medicare UPIN
VA002567Medicare PIN