Provider Demographics
NPI:1972670412
Name:WOOD, KAREN ELIZABETH (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ELIZABETH
Last Name:WOOD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:645 KANAWHA AVE
Mailing Address - Street 2:
Mailing Address - City:RAINELLE
Mailing Address - State:WV
Mailing Address - Zip Code:25962-1013
Mailing Address - Country:US
Mailing Address - Phone:304-438-6188
Mailing Address - Fax:304-438-6819
Practice Address - Street 1:1502 MEADOW BRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:MEADOW BRIDGE
Practice Address - State:WV
Practice Address - Zip Code:25976
Practice Address - Country:US
Practice Address - Phone:304-484-7755
Practice Address - Fax:304-484-6205
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV25538363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner