Provider Demographics
NPI:1083206742
Name:WOODS, KIMBERLY RAE (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RAE
Last Name:WOODS
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 OLD HARRODS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2553
Mailing Address - Country:US
Mailing Address - Phone:502-518-6007
Mailing Address - Fax:
Practice Address - Street 1:209 OLD HARRODS CREEK RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2553
Practice Address - Country:US
Practice Address - Phone:502-518-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015815363LP0808X
KY1130985163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health