Provider Demographics
NPI:1235296617
Name:WOODS, SUZANNE L (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:L
Last Name:WOODS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 C MIDDLETOWN PARK PLACE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243
Mailing Address - Country:US
Mailing Address - Phone:502-244-9858
Mailing Address - Fax:502-244-9575
Practice Address - Street 1:301 C MIDDLETOWN PARK PLACE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243
Practice Address - Country:US
Practice Address - Phone:502-244-9858
Practice Address - Fax:502-244-9575
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA09946NP363LP0200X
KY6042P2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics