Provider Demographics
NPI:1205288123
Name:WOOLFORD, MEISHA (BSN, RN)
Entity type:Individual
Prefix:
First Name:MEISHA
Middle Name:
Last Name:WOOLFORD
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 FOXTAIL DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-1494
Mailing Address - Country:US
Mailing Address - Phone:410-330-1433
Mailing Address - Fax:
Practice Address - Street 1:753 FOXTAIL DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-1494
Practice Address - Country:US
Practice Address - Phone:410-330-1433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-02
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR186884163WC0400X, 163WM0102X, 163WX0002X, 163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk