Healthcare Provider Details

I. General information

NPI: 1700070901
Provider Name (Legal Business Name): ALICE EVELYN WOODRUFF FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2007
Last Update Date: 11/09/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 PARK AVE
ATHENS GA
30601-1722
US

IV. Provider business mailing address

108 PARK AVE
ATHENS GA
30601-1722
US

V. Phone/Fax

Practice location:
  • Phone: 706-546-1333
  • Fax: 706-546-6807
Mailing address:
  • Phone: 706-546-1333
  • Fax: 706-546-6807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberRN123354 NP
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: