Kellie Woodruff
Nurse Practitioner - Pediatrics
411 E Chestnut St # Street7
Louisville
, Kentucky 40202-1713
Kellie Woodruff
Nurse Practitioner - Pediatrics
411 E Chestnut St # Street7
Louisville
, Kentucky 40202-1713
(502) 272-5116
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About
Features
Specialties
- Nurse Practitioner - Pediatrics
Languages spoken
- English
Location
First Address
- Kellie Woodruff
- Po Box 776879
- Chicago, IL
- Zip : 60677-6879
- Fax : (502) 272-5116
- Phone : (502) 588-9490
Second Address
- Kellie Woodruff
- 411 E Chestnut St # Street7
- Louisville, KY
- Zip : 40202-1713
- Fax : (502) 588-3401
- Phone : (502) 588-3400
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner - Pediatrics | 3003826 | KY |
National Provider Identifier
| NPI | 1013988351 |
|---|---|
| Provider Name | Kellie Woodruff |
| First Address | Chicago, IL 60677-6879 |
| Second Address | Louisville, KY 40202-1713 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/01/2006 |
| Last Update Date | 11/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200889660 | (05) | IN |
| 7801454500 | (05) | KY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.