Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1-153670 | AL |
N | 363LG0600X | Nurse Practitioner - Gerontology | 1-153670 | AL |
NPI | 1013483338 |
---|---|
Provider Name | Tarah Leigh Woodfin |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35233-2110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2018 |
Last Update Date | 15/03/2019 |