Individual
STACEY LYNNE WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1329 LUSITANA ST, SUITE 703, HONOLULU, HI 96813-2429
(808) 526-2477
(808) 528-3671
Mailing address
1329 LUSITANA ST, SUITE 703, HONOLULU, HI 96813-2429
(808) 526-2477
(808) 528-3671
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD-17258
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M9748
TEXAS MEDICAL LICENSE
TX
01
—
MD-17258
HAWAII MEDICAL LICENSE
HI
Enumeration date
06/13/2007
Last updated
09/09/2014
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