Individual
SUSAN WOLCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM, RN
Contact information
Practice address
703 S A ST, MOUNT SHASTA, CA 96067
(562) 334-5706
(626) 610-3825
Mailing address
5105 PLUM AVE, MOUNT SHASTA, CA 96067-9155
(530) 926-5395
Taxonomy
Speciality
Code
Description
License number
State
163WP1700X
Perinatal Registered Nurse
619799
CA
176B00000X
Midwife
Primary
166
CA
Other
Enumeration date
07/09/2006
Last updated
06/20/2018
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