Individual
MICHELE M WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
528 N BARRY ST, OLEAN, NY 14760-2612
(716) 543-3255
(716) 543-3256
Mailing address
908 NIAGARA FALLS BLVD STE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-3302
(716) 692-4342
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
370048
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04345906
—
NY
Enumeration date
02/02/2012
Last updated
03/14/2019
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