Provider Demographics
NPI:1730300310
Name:WOODRUFF, GERALDINE L
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:L
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 MILLVILLE OXFORD ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-4324
Mailing Address - Country:US
Mailing Address - Phone:513-844-8619
Mailing Address - Fax:513-844-6618
Practice Address - Street 1:25 HERD COURT
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-4324
Practice Address - Country:US
Practice Address - Phone:513-892-2052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2713086374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide