Provider Demographics
NPI:1053087031
Name:WOODS, KATIE SUE (FNP-C)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:SUE
Last Name:WOODS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 VON RUCK RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-3340
Mailing Address - Country:US
Mailing Address - Phone:804-210-7898
Mailing Address - Fax:
Practice Address - Street 1:10900 NUCKOLS RD STE 110
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-9246
Practice Address - Country:US
Practice Address - Phone:336-589-9456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184407207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine