| NPI | 1366437238 |
|---|---|
| Former Name | KELLY ELIZABETH WOODARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 13454) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3200P) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN115204) | |
| 363L00000X Nurse Practitioner (Licence: TN 13454) | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2014-05-15 |