Provider Demographics
NPI:1467826008
Name:WOOLLEY, KRISTEN ELAINE
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ELAINE
Last Name:WOOLLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19111 FOREST RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-3119
Mailing Address - Country:US
Mailing Address - Phone:936-494-5109
Mailing Address - Fax:
Practice Address - Street 1:19111 FOREST RIDGE DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-3119
Practice Address - Country:US
Practice Address - Phone:936-494-5109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health