Individual
STEPHANIE B. WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6TH AVENUE & SPRUCE ST, WEST READIING, PA 19611-1428
(484) 628-8269
Mailing address
PO BOX 13579, READING, PA 19612-3579
(494) 628-0799
(484) 334-7026
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN503879L
PA
363L00000X
Nurse Practitioner
TP005180V
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
080129
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115708
GEISINGER
PA
01
—
1585280
GATEWAY
PA
01
—
2053881
HIGHMARK
PA
01
—
3530936000
IBC
PA
01
—
50076310
CAPITAL ADVANTAGE
PA
01
—
9123457
AETNA
PA
Enumeration date
03/26/2008
Last updated
11/19/2014
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