Healthcare Provider Details

I. General information

NPI: 1275201741
Provider Name (Legal Business Name): LEAH H WOOLRIDGE APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 N CROATAN HWY STE 9
KITTY HAWK NC
27949-3990
US

IV. Provider business mailing address

PO BOX 1048
KITTY HAWK NC
27949-1048
US

V. Phone/Fax

Practice location:
  • Phone: 252-581-8404
  • Fax: 833-764-5804
Mailing address:
  • Phone: 252-581-8404
  • Fax: 833-764-5804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberWOOL-X0MMS
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: