Provider Demographics
NPI:1316107758
Name:WOODRUFF, CHERYL C (DPH)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:C
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38351-1422
Mailing Address - Country:US
Mailing Address - Phone:731-968-6979
Mailing Address - Fax:731-968-5152
Practice Address - Street 1:6 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:TN
Practice Address - Zip Code:38351-1422
Practice Address - Country:US
Practice Address - Phone:731-968-6979
Practice Address - Fax:731-968-5152
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4434851Medicaid
TN4136530001Medicare NSC