Provider Demographics
NPI:1649356684
Name:WOOLINGTON, MARY CHRISTINE (FNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CHRISTINE
Last Name:WOOLINGTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5299 DTC BLVD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3321
Mailing Address - Country:US
Mailing Address - Phone:303-770-0507
Mailing Address - Fax:303-770-0501
Practice Address - Street 1:200 W 136TH AVENUE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234
Practice Address - Country:US
Practice Address - Phone:303-770-0507
Practice Address - Fax:303-770-0501
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO109668363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO43170862Medicaid
CO109668OtherLICENSE
CO109668OtherLICENSE
CO808541Medicare Oscar/Certification
CO808541Medicare UPIN