Provider Demographics
NPI:1902084437
Name:WOODRIDGE, KAREN (LPN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WOODRIDGE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 CANVASBACK CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7003
Mailing Address - Country:US
Mailing Address - Phone:301-343-0170
Mailing Address - Fax:301-218-5915
Practice Address - Street 1:1210 CANVASBACK CT
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-7003
Practice Address - Country:US
Practice Address - Phone:301-343-0170
Practice Address - Fax:301-218-5915
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2593164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse