Individual
MARY TERESA WOODRUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
2366 BATTLEFIELD PKWY, FORT OGLETHORPE, GA 30742-4030
(706) 866-7384
Mailing address
2366 BATTLEFIELD PKWY, FORT OGLETHORPE, GA 30742-4030
(706) 866-7384
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
079456
GA
363LP0200X
Pediatric Nurse Practitioner
69737
TN
Other
Enumeration date
01/04/2008
Last updated
01/04/2008
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