Provider Demographics
NPI:1013351485
Name:WOODWARD, KATHERINE ASHLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ASHLEY
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ASHLEY
Other - Last Name:MELNICK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:844 KEMPSVILLE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3927
Mailing Address - Country:US
Mailing Address - Phone:757-261-0700
Mailing Address - Fax:757-261-0701
Practice Address - Street 1:844 KEMPSVILLE RD STE 204
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3927
Practice Address - Country:US
Practice Address - Phone:757-261-0700
Practice Address - Fax:757-261-0701
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004262363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant