Provider Demographics
NPI:1356942197
Name:WOODRUFF, DAVID (PHD, APRN)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:WOODRUFF
Suffix:
Gender:M
Credentials:PHD, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 NORTHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-5714
Mailing Address - Country:US
Mailing Address - Phone:330-888-9446
Mailing Address - Fax:
Practice Address - Street 1:1530 NORTHWOOD AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-5714
Practice Address - Country:US
Practice Address - Phone:330-888-9446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-211701163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development