Provider Demographics
NPI:1386896546
Name:BILLS WOODS, KATHARINE (PA)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:BILLS WOODS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 STEUBEN ST
Mailing Address - Street 2:
Mailing Address - City:MONTOUR FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14865-9648
Mailing Address - Country:US
Mailing Address - Phone:607-535-8626
Mailing Address - Fax:607-210-1983
Practice Address - Street 1:250 STEUBEN ST
Practice Address - Street 2:
Practice Address - City:MONTOUR FALLS
Practice Address - State:NY
Practice Address - Zip Code:14865-9648
Practice Address - Country:US
Practice Address - Phone:607-535-8626
Practice Address - Fax:607-210-1983
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2640363AS0400X
NY029077363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2640OtherLICENSE