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Individual

TERRELL WOOTTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
420 BRACEY LN, SOUTH HILL, VA 23970-1631
(434) 447-7765
Mailing address
PO BOX 623, SOUTH HILL, VA 23970-0623
(434) 447-7765
(434) 447-2845

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
0024056113
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0024056113
CNM VA LICENSE
VA
Enumeration date
10/23/2006
Last updated
12/10/2014
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