Provider Demographics
NPI:1972544963
Name:WOODRUFF, CHRISTIE L (NP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:L
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4371 CLARKS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-3359
Mailing Address - Country:US
Mailing Address - Phone:770-297-7277
Mailing Address - Fax:
Practice Address - Street 1:4371 CLARKS BRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30506
Practice Address - Country:US
Practice Address - Phone:770-983-7987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN061075363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily