Individual
THERESA P WOOLBRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 LINCOLN PKWY STE 202, HATTIESBURG, MS 39402-3261
(601) 288-8050
Mailing address
1 LINCOLN PKWY STE 202, HATTIESBURG, MS 39402-3261
(601) 288-8050
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R541265
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06606224
—
MS
01
—
500011980
MEDICARE RAILROAD
MS
Enumeration date
07/05/2006
Last updated
07/08/2007
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