Basic Information
Provider Information
NPI: 1851505887
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WOODRUFF
FirstName: JENNIFER
MiddleName: SPISER
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: 16152 W PALM LN
Address2:  
City: GOODYEAR
State: AZ
PostalCode: 853957121
CountryCode: US
TelephoneNumber: 6232257241
FaxNumber:  
Practice Location
Address1: 9930 W INDIAN SCHOOL RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850375902
CountryCode: US
TelephoneNumber: 6238467558
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/09/2007
LastUpdateDate: 05/04/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102XRN115801AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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