Individual
KATHLEEN ANN WOODS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112
(314) 367-5820
(314) 367-7010
Mailing address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1999136138
MO
363LF0000X
Family Nurse Practitioner
R878465
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04950007
—
MS
05
—
1780884916
—
MO
01
—
431560263
TRICARE WEST
—
Enumeration date
07/25/2007
Last updated
08/01/2018
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