Individual
LISSA WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3219 CENTRAL AVE, KEARNEY, NE 68847-2949
(308) 865-2808
Mailing address
10 E 31ST ST, KEARNEY, NE 68847-2908
(308) 865-2808
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19918
NE
Other
Enumeration date
11/22/2005
Last updated
02/01/2021
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