Healthcare Provider Details

I. General information

NPI: 1447948435
Provider Name (Legal Business Name): MS. WOODLYNE JEAN-BAPTISTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: WOODLYNE VALME RN

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 MUNICIPAL DR
MCHENRY IL
60050-5483
US

IV. Provider business mailing address

345 INDIAN RIDGE TRL
WAUCONDA IL
60084-3001
US

V. Phone/Fax

Practice location:
  • Phone: 815-759-2306
  • Fax:
Mailing address:
  • Phone: 904-864-7561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.342159
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: