| Doctor Name: | MARY TERESA WOODRUFF |
| NPI Number: | 1740465129 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPNP-PC |
| License Number: | 69737 |
| Business Practice Address: | 2366 Battlefield Pkwy Fort Oglethorpe, GA - 307424030 |
| Business Phone Number: | 7068667384 |
| Business Fax Number: | |
| Mailing Address: | 2366 Battlefield Pkwy, FORT OGLETHORPE |
| State: | GA |
| Postal Code: | 307424030 |
| Phone Number: | 7068667384 |
| Fax Number: | |
| NPI Enumeration Date: | 01/04/2008 |
| NPI Last Update Date: | 01/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 69737 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |