Provider Demographics
NPI:1346492568
Name:WOOLUM, JANICE GAIL (ARNP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:GAIL
Last Name:WOOLUM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 S LIMESTONE
Mailing Address - Street 2:L543
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-5045
Mailing Address - Fax:859-257-2418
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:L543
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-5045
Practice Address - Fax:859-257-2418
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5791363LC0200X
KY30005791363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner