MEDICARE: MRS. ELIZABETH WOOKEY CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	200850	SD

General Provider Information

NPI Number	:	1841136223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH WOOKEY CNP

Provider Business Mailing Address
First Line	:	44721 KAMPESKA CIR
Second Line	:
City	:	WATERTOWN
State	:	SD
Zip	:	57201-7698
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1014 14TH ST SE
Second Line	:
City	:	WATERTOWN
State	:	SD
Zip	:	57201-5328
Country	:	US
Telephone Number	:	605-753-0920
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2026
Last Update Date	:	06/02/2026

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