Provider Demographics
NPI:1124825922
Name:WOOLFORD, WYKESHA (RN IBCLC)
Entity type:Individual
Prefix:
First Name:WYKESHA
Middle Name:
Last Name:WOOLFORD
Suffix:
Gender:
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 LAYSAN TEAL COURT
Mailing Address - Street 2:
Mailing Address - City:CHURCH HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21623
Mailing Address - Country:US
Mailing Address - Phone:443-449-7502
Mailing Address - Fax:
Practice Address - Street 1:245 LAYSAN TEAL COURT
Practice Address - Street 2:
Practice Address - City:CHURCH HILL
Practice Address - State:MD
Practice Address - Zip Code:21623-2162
Practice Address - Country:US
Practice Address - Phone:617-290-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDL-311303163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant