Individual
SHELLEY R WOOLDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3999 DUTCHMANS LN, 7B, LOUISVILLE, KY 40207-4729
(502) 896-4711
(502) 896-4791
Mailing address
PO BOX 950202, LOUISVILLE, KY 40295-0202
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3004714
KY
363LP2300X
Primary Care Nurse Practitioner
4714P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000735021
ANTHEM- NSS
KY
05
—
201083440
—
IN
01
—
50034547
PASSPORT- NORTON SURGICAL SPECIALISTS
KY
05
—
78015500
—
KY
Enumeration date
06/13/2006
Last updated
12/06/2018
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