Provider Demographics
NPI:1538498738
Name:BROWN-WOODHULL, RONNIE ABUSH (NP)
Entity Type:Individual
Prefix:DR
First Name:RONNIE
Middle Name:ABUSH
Last Name:BROWN-WOODHULL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:RONNIE
Other - Middle Name:ABUSH
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4530 E MONTE CRISTO AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4236
Mailing Address - Country:US
Mailing Address - Phone:602-494-4900
Mailing Address - Fax:
Practice Address - Street 1:PARTNERS IN RECOVERY - WEST VALLEY CLINIC
Practice Address - Street 2:14100 W 83RD AVENUE STE 100
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381
Practice Address - Country:US
Practice Address - Phone:623-583-0232
Practice Address - Fax:623-583-1830
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-17
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3534363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health