Individual
TODD A. WOOLLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2201 N BROADWELL AVE, GRAND ISLAND, NE 68803-2153
(308) 382-3660
(308) 389-5111
Mailing address
2201 N BROADWELL AVE, GRAND ISLAND, NE 68803-2153
(308) 382-3660
(308) 389-5111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21191
NE
207Q00000X
Family Medicine Physician
34701
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0270801
—
IA
01
—
30555
WELLMARK BC/BS
IA
Enumeration date
08/12/2005
Last updated
08/16/2022
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