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Individual
LISA MARIE WOOTEN
Active
Individual
LISA MARIE WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3007613
KY
363LA2200X
Adult Health Nurse Practitioner
3007613
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100218830
—
KY
Enumeration date
09/13/2012
Last updated
05/18/2021
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