Provider Demographics
NPI:1467706812
Name:WOODS, KRISKA MARIE CARANDANG (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:KRISKA MARIE
Middle Name:CARANDANG
Last Name:WOODS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 BETHANY BROOK LN
Mailing Address - Street 2:APT. 201
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4868
Mailing Address - Country:US
Mailing Address - Phone:864-421-2999
Mailing Address - Fax:
Practice Address - Street 1:5100 BEATTIES FORD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-2357
Practice Address - Country:US
Practice Address - Phone:704-391-9341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22741183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist