Provider Demographics
NPI:1932821386
Name:WOOTON, CATHERINE BERNICE (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:BERNICE
Last Name:WOOTON
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 W WEBB AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-3706
Mailing Address - Country:US
Mailing Address - Phone:336-228-8316
Mailing Address - Fax:336-227-9750
Practice Address - Street 1:3804 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-9134
Practice Address - Country:US
Practice Address - Phone:336-524-0304
Practice Address - Fax:336-584-4387
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC152284163W00000X, 163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse