Provider Demographics
NPI:1851096051
Name:WOODCOCK, CIERRA PAYTON
Entity Type:Individual
Prefix:
First Name:CIERRA
Middle Name:PAYTON
Last Name:WOODCOCK
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 1:460 CEDAR GROVE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:BEE SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:42207-9321
Mailing Address - Country:US
Mailing Address - Phone:270-597-4071
Mailing Address - Fax:
Practice Address - Street 1:500 S PRESTON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1702
Practice Address - Country:US
Practice Address - Phone:502-852-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program