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General NPI Number Information
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NPI Number | 1538909486
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Entity Type | Individual
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Provider Name | TRISTIN WOODRUFF PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1908 E FRANKLIN BLVD STE 100
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City | GASTONIA
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State | NC
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Zip | 28054-4742
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Country | US
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Telephone | 704-271-1215
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Fax |
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Provider Business Mailing Address
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Address Line | 4203 BLU HERON RD UNIT B
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City | PINEVILLE
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State | NC
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Zip | 28134-8647
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Country | US
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Telephone | 850-758-9355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9118849
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License Number State | FL
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