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General NPI Number Information
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NPI Number | 1811193980
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Entity Type | Individual
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Provider Name | ANITA BLACK WOOLARD FNP
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Gender | Female
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 501 W 15TH ST
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City | WASHINGTON
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State | NC
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Zip | 27889-3565
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Country | US
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Telephone | 252-975-2667
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Fax | 252-975-2507
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Provider Business Mailing Address
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Address Line | 501 W 15TH ST
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City | WASHINGTON
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State | NC
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Zip | 27889-3565
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Country | US
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Telephone | 252-975-2667
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0050-03121
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License Number State | NC
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