Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 6042P | KY |
N | 363LP0200X | Nurse Practitioner - Pediatrics | COA09946NP | OH |
NPI | 1235296617 |
---|---|
Provider Name | Mrs. Suzanne L Woods |
First Address | Louisville, KY 40243 |
Second Address | Louisville, KY 40243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 12/03/2014 |