Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 30005791 | KY |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 5791 | KY |
NPI | 1346492568 |
---|---|
Provider Name | Janice Gail Woolum |
First Address | Lexington, KY 40536-0001 |
Second Address | Lexington, KY 40536-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 15/05/2015 |