Provider Demographics
NPI:1457903833
Name:WOOKEY, ABBY LYNNE (PA)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:LYNNE
Last Name:WOOKEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:LYNNE
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 1210
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-6210
Mailing Address - Country:US
Mailing Address - Phone:605-882-7777
Mailing Address - Fax:605-882-7819
Practice Address - Street 1:401 9TH AVE NW
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-1548
Practice Address - Country:US
Practice Address - Phone:605-882-7777
Practice Address - Fax:605-882-7819
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant