Healthcare Provider Details

I. General information

NPI: 1568422475
Provider Name (Legal Business Name): COLLEEN THERESA WOJCIECHOWSKI MSN, GNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 FULTON ST
DURHAM NC
27705-3875
US

IV. Provider business mailing address

313 WAVERLY HILLS DR
CARY NC
27519-9776
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-0411
  • Fax: 919-286-6875
Mailing address:
  • Phone: 919-447-0313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number600131
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: