Provider Demographics
NPI:1548229479
Name:WOOD, AMY KRISTEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:KRISTEN
Last Name:WOOD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:KRISTEN
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23226 RIDGE CREST CT
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24202-4674
Mailing Address - Country:US
Mailing Address - Phone:276-466-8280
Mailing Address - Fax:
Practice Address - Street 1:951 HIGHWAY 126
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-3353
Practice Address - Country:US
Practice Address - Phone:423-844-6840
Practice Address - Fax:423-844-0363
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000010366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist