Provider Demographics
NPI:1528789765
Name:WOODRUFF, JENNIFER ANN
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1301
Mailing Address - Street 2:
Mailing Address - City:SEALY
Mailing Address - State:TX
Mailing Address - Zip Code:77474-1301
Mailing Address - Country:US
Mailing Address - Phone:281-900-8662
Mailing Address - Fax:833-260-3340
Practice Address - Street 1:600 2ND ST
Practice Address - Street 2:
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474-2229
Practice Address - Country:US
Practice Address - Phone:281-900-8662
Practice Address - Fax:833-260-3340
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No174H00000XOther Service ProvidersHealth Educator
No251K00000XAgenciesPublic Health or Welfare