Individual
KELLIE WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
411 E CHESTNUT ST # STREET7, LOUISVILLE, KY 40202-1713
(502) 588-3400
(502) 588-3401
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
3003826
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200889660
—
IN
05
—
7801454500
—
KY
Enumeration date
01/26/2006
Last updated
10/11/2020
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