Provider Demographics
NPI:1952890261
Name:WOODRUFF, SUSAN W (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:W
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 33RD ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-2036
Mailing Address - Country:US
Mailing Address - Phone:504-837-7760
Mailing Address - Fax:504-346-1596
Practice Address - Street 1:3040 33RD ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-2036
Practice Address - Country:US
Practice Address - Phone:504-837-7760
Practice Address - Fax:504-837-7754
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP09274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily