Provider Demographics
NPI:1407335151
Name:WOOLCOCK, JUDY (RN)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:WOOLCOCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S PARK CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4625
Mailing Address - Country:US
Mailing Address - Phone:843-953-1261
Mailing Address - Fax:843-953-1276
Practice Address - Street 1:1 S PARK CIR STE 101
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4625
Practice Address - Country:US
Practice Address - Phone:843-953-1261
Practice Address - Fax:843-953-1276
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRN231459R163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management