Individual
STEPHANIE WOODKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111-3220
(816) 932-3679
Mailing address
901 E 104TH ST, MAILSTOP 400S, KANSAS CITY, MO 64131
(816) 502-8756
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2017017856
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/23/2017
Last updated
09/10/2018
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