Healthcare Provider Details

I. General information

NPI: 1669207528
Provider Name (Legal Business Name): CAITLIN WOODRUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 10/13/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE - ML 11013
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

2413 MILLSTREAM LN
BURLINGTON KY
41005-8116
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0036994
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0036994
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: