Provider Demographics
NPI:1083198170
Name:WOOD, EKATERINA (FNP-C PMHNP)
Entity type:Individual
Prefix:
First Name:EKATERINA
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:FNP-C PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 RICKETTS DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3676
Mailing Address - Country:US
Mailing Address - Phone:540-535-1112
Mailing Address - Fax:
Practice Address - Street 1:36 RICKETTS DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3676
Practice Address - Country:US
Practice Address - Phone:540-535-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2024-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176647363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health