Provider Demographics
NPI:1760204861
Name:WOODRUFF, ERICA ANN (CHW, CPHT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:ANN
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:CHW, CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 OXFORD LN
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-4647
Mailing Address - Country:US
Mailing Address - Phone:810-444-4590
Mailing Address - Fax:
Practice Address - Street 1:2041 OXFORD LN
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-4647
Practice Address - Country:US
Practice Address - Phone:810-444-4590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker