Healthcare Provider Details

I. General information

NPI: 1710840483
Provider Name (Legal Business Name): KATIE ANN WOODS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 JOE FRANK HARRIS PKWY SE STE 200
CARTERSVILLE GA
30120-2161
US

IV. Provider business mailing address

304 GOLDEN CT
CANTON GA
30114-6804
US

V. Phone/Fax

Practice location:
  • Phone: 470-490-2768
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN-NP257838
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: