Healthcare Provider Details

I. General information

NPI: 1730139668
Provider Name (Legal Business Name): BARBARA M WOFFORD RN,ARNP,MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL VILLAGE DR
EDGEWOOD KY
41017-3408
US

IV. Provider business mailing address

PO BOX 635283 ST. ELIZABETH PHYSICIANS
CINCINNATI OH
45263-5283
US

V. Phone/Fax

Practice location:
  • Phone: 859-301-5900
  • Fax: 859-301-5940
Mailing address:
  • Phone: 859-344-5555
  • Fax: 859-344-5552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number3002307
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3002307
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: