Provider Demographics
NPI:1104655364
Name:WOODRUFF, MARGARET RAE
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:RAE
Last Name:WOODRUFF
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 S LOOP RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-5446
Mailing Address - Country:US
Mailing Address - Phone:859-301-3800
Mailing Address - Fax:859-301-3800
Practice Address - Street 1:413 S LOOP RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5446
Practice Address - Country:US
Practice Address - Phone:859-301-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-27
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program