Healthcare Provider Details

I. General information

NPI: 1366235301
Provider Name (Legal Business Name): SARA MARIE WOODS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EVANS ARMY COMMUNITY HOSPITAL, 1650 COCHRANE CIR B7500
FORT CARSON CO
80913
US

IV. Provider business mailing address

EVANS ARMY COMMUNITY HOSPITAL, 1650 COCHRANE CIR B7500
FORT CARSON CO
80913
US

V. Phone/Fax

Practice location:
  • Phone: 814-860-6159
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86300803
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: