Provider Demographics
NPI:1609426006
Name:WOODRUFF, WHITNEY SUZANNE (APRN)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:SUZANNE
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2485 GRANT AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-2676
Mailing Address - Country:US
Mailing Address - Phone:385-277-6604
Mailing Address - Fax:
Practice Address - Street 1:2485 GRANT AVE STE 320
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-2676
Practice Address - Country:US
Practice Address - Phone:385-377-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8820373-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner