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General NPI Number Information
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NPI Number | 1669094751
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Entity Type | Individual
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Provider Name | LILA WOOTEN DNP
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Gender | Female
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 2877 E FOUNTAIN BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-2312
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Country | US
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Telephone | 719-454-6009
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Fax | 719-258-1319
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Provider Business Mailing Address
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Address Line | PO BOX 746081
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City | ATLANTA
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State | GA
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Zip | 30374-6081
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Country | US
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Telephone | 312-733-9730
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Fax | 773-866-8014
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.0999876
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN61057103
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | EP61078944
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | N261065345
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License Number State | WA
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