Provider Demographics
NPI:1538251533
Name:WOODBERRY, RUDYEA LESHEA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:RUDYEA
Middle Name:LESHEA
Last Name:WOODBERRY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 EATONS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-1004
Mailing Address - Country:US
Mailing Address - Phone:615-313-7061
Mailing Address - Fax:
Practice Address - Street 1:220 ATHENS WAY
Practice Address - Street 2:STE 150
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1311
Practice Address - Country:US
Practice Address - Phone:615-312-4003
Practice Address - Fax:800-952-4488
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist