Individual
LESLIE S WOOLDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6401 PRAIRIE ST, SUITE 1700, NORTON SHORES, MI 49444-7840
(231) 727-7944
(231) 724-7812
Mailing address
PO BOX 1847, MUSKEGON, MI 49443-1847
(231) 727-4444
(231) 727-4789
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704099434
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4837110
—
MI
01
—
MI1763011
MEDICARE PTAN
MI
Enumeration date
06/15/2006
Last updated
12/04/2012
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