Lisa Marie Wooten, APRN
Nurse Practitioner in Louisville, KY. Individual provider (NPI-1).
NPI number1033469366
StatusActive
Last updated in NPPESMay 18, 2021
Details
- NPI
- 1033469366
- Entity type
- Individual (NPI-1)
- Name
- Lisa Marie Wooten
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 13, 2012
- Certification date
- May 12, 2021
- Last updated
- May 18, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 3007613 | KY | Yes |
| 363LA2200X | Nurse Practitioner, Adult Health | 3007613 | KY |
Practice location
4402 Churchman Ave Ste 201Louisville, KY 40215-3100
Phone 502-416-0207
Mailing address
Po Box 909Louisville, KY 40201-0909
Phone 502-416-0207
Other practice locations
2401 Terra Crossing Blvd Ste 410
Louisville, KY 40245-5371
Louisville, KY 40245-5371
Phone 502-888-1988
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