Provider Demographics
NPI:1104343318
Name:WOOLFOLK, CENTERIA GREEN (FNP-C)
Entity type:Individual
Prefix:MISS
First Name:CENTERIA
Middle Name:GREEN
Last Name:WOOLFOLK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CENTERIA
Other - Middle Name:
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:529 W COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-3219
Mailing Address - Country:US
Mailing Address - Phone:931-270-9729
Mailing Address - Fax:
Practice Address - Street 1:529 W COMMERCE ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-3219
Practice Address - Country:US
Practice Address - Phone:931-270-9729
Practice Address - Fax:931-270-9926
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily