Provider Demographics
NPI:1760032320
Name:WOOLLEY, NANCY J
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:WOOLLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7304 S EDINBURG PL
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-9400
Mailing Address - Country:US
Mailing Address - Phone:402-850-3888
Mailing Address - Fax:
Practice Address - Street 1:7304 S EDINBURG PL
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-9400
Practice Address - Country:US
Practice Address - Phone:402-850-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider