Provider Demographics
NPI:1558594424
Name:WOODRUFF, VALERIE DENENE (APN)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:DENENE
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:DENENE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1521 N 10TH ST STE F
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72315-1424
Mailing Address - Country:US
Mailing Address - Phone:870-780-6832
Mailing Address - Fax:
Practice Address - Street 1:1521 N 10TH ST STE F
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-1424
Practice Address - Country:US
Practice Address - Phone:870-780-6832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily