Woodruff, Kellie
Woodruff, Kellie is an individual health care provider with primary practice located at 411 E Chestnut St # Street7 , Louisville KY 40202-1713. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Woodruff, Kellie can be contacted via phone (502) 588-3400.Contact Information
Primary practice address
411 E Chestnut St # Street7
Louisville KY 40202-1713
Phone: (502) 588-3400
Fax: (502) 588-3401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 3003826 | Kentucky |
Profile Details
| NPI number | 1013988351 |
|---|---|
| LBN Legal business name | Woodruff, Kellie |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Oct 11th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013988351 | NPPES |
| Indiana | MEDICAID | 200889660 | |
| Indiana | MEDICAID | 7801454500 |
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