Provider Demographics
NPI:1174752976
Name:WOODWARD, KATHLEEN MAY (PA-C)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MAY
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11116 MEDICAL CAMPUS RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11110 MEDICAL CAMPUS RD STE 147
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6755
Practice Address - Country:US
Practice Address - Phone:301-714-4350
Practice Address - Fax:301-714-4353
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2025-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK5535363A00000X
MDC0004001363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant