MEDICARE: KATELYN WOODS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	5302414397	MI

General Provider Information

NPI Number	:	1003540790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN WOODS

Provider Business Mailing Address
First Line	:	409 WILSON DR
Second Line	:
City	:	MIDLAND
State	:	MI
Zip	:	48642-3370
Country	:	US
Telephone Number	:	989-600-5199
Fax Number	:

Provider Business Practice Location Address
First Line	:	595 N PINE RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-9190
Country	:	US
Telephone Number	:	989-891-1510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2022
Last Update Date	:	07/11/2022

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Directions to “ KATELYN WOODS ” Practice Location

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