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General NPI Number Information
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NPI Number | 1932917101
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Entity Type | Individual
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Provider Name | JENNIFER LENE WOFFORD PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 100 E MARKET ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-1969
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Country | US
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Telephone | 502-579-8253
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Fax |
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Provider Business Mailing Address
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Address Line | 3191 HARBOR BLVD STE A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-6755
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Country | US
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Telephone | 941-883-4518
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11036263
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4030684
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License Number State | KY
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