Healthcare Provider Details

I. General information

NPI: 1982550711
Provider Name (Legal Business Name): AUBREY PAIGE WOOTEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LONE OAK RD STE 124
PADUCAH KY
42001-4435
US

IV. Provider business mailing address

6430 JOPPA LANDING RD
KEVIL KY
42053-8733
US

V. Phone/Fax

Practice location:
  • Phone: 812-625-3070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4005311
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: