Individual
MRS. DIANE M WOODFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-4600
(215) 707-9697
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-4600
(215) 707-9697
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
UP004883B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102900511
—
PA
Enumeration date
07/09/2012
Last updated
06/26/2018
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