Provider Demographics
NPI:1518504547
Name:WOOD, KARA (RDN/LD)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:RDN/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 OAKCREST ST APT 307
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-5180
Mailing Address - Country:US
Mailing Address - Phone:417-664-3066
Mailing Address - Fax:
Practice Address - Street 1:105 E 9TH ST
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2209
Practice Address - Country:US
Practice Address - Phone:319-467-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA097844133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered