Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 40861 | KY |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 43509 | TN |
NPI | 1134346430 |
---|---|
Provider Name | Dr. Courtney Stroupe Woodmansee |
First Address | Memphis, TN 38104-6727 |
Second Address | Memphis, TN 38104-6727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 21/07/2008 |