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NPI Code Detail

MEDICARE: KAITLYN WOODS

MEDICARE:   KAITLYN  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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1356929269
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN WOODS
Provider Business Mailing Address
First Line : 420 W VIRGINIA AVE
Second Line :
City : MORGANTOWN
State : WV
Zip : 26501-6434
Country : US
Telephone Number : 304-376-5600
Fax Number :
Provider Business Practice Location Address
First Line : 420 W VIRGINIA AVE
Second Line :
City : MORGANTOWN
State : WV
Zip : 26501-6434
Country : US
Telephone Number : 304-376-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2021
Last Update Date : 03/31/2021

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Directions to “ KAITLYN WOODS ” Practice Location

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