Healthcare Provider Details

I. General information

NPI: 1609426006
Provider Name (Legal Business Name): WHITNEY SUZANNE WOODRUFF APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3817 N 2550 W
FARR WEST UT
84404-8650
US

IV. Provider business mailing address

3817 N 2550 W
FARR WEST UT
84404-8650
US

V. Phone/Fax

Practice location:
  • Phone: 385-377-6604
  • Fax: 385-449-2838
Mailing address:
  • Phone: 385-377-6604
  • Fax: 385-449-2838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8820373-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: