Provider Demographics
NPI:1528640216
Name:WOODRUFF, NANCY COLEEN (CST)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:COLEEN
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-6136
Mailing Address - Country:US
Mailing Address - Phone:850-500-7527
Mailing Address - Fax:850-855-4030
Practice Address - Street 1:600 E GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-6136
Practice Address - Country:US
Practice Address - Phone:850-500-7527
Practice Address - Fax:850-855-4030
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist