Provider Demographics
NPI:1417594862
Name:WOODS, KRISTIN ANN (FNP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:ANN
Last Name:WOODS
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 E MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-5646
Mailing Address - Country:US
Mailing Address - Phone:928-492-9222
Mailing Address - Fax:928-492-9223
Practice Address - Street 1:127 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5646
Practice Address - Country:US
Practice Address - Phone:928-492-9222
Practice Address - Fax:928-492-9223
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ234656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily