Individual
MS. JACQUELYN MARIE WOOLDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
3901 E 32ND ST, JOPLIN, MO 64804-3312
(417) 347-7540
(417) 347-7549
Mailing address
PO BOX 2526, JOPLIN, MO 64803-2526
(417) 347-7540
(417) 347-7549
Taxonomy
Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
2000174217
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425193406
—
MO
Enumeration date
10/03/2006
Last updated
04/24/2019
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