Healthcare Provider Details

I. General information

NPI: 1558469288
Provider Name (Legal Business Name): PATRICIA ANN WOELFLE-ANDERSON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 RESNIK RD
PLYMOUTH MA
02360-4844
US

IV. Provider business mailing address

29 HARVEST DR
KINGSTON MA
02364-1825
US

V. Phone/Fax

Practice location:
  • Phone: 508-746-0754
  • Fax: 508-747-7867
Mailing address:
  • Phone: 781-582-9589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number157028
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: