Provider Demographics
NPI:1154743839
Name:WOAHLOE, CAROLYN (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:WOAHLOE
Suffix:
Gender:
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8617 GRAY SHALE DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76179-4378
Mailing Address - Country:US
Mailing Address - Phone:972-890-6684
Mailing Address - Fax:
Practice Address - Street 1:817 TOWNE CT STE 100
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76179-1219
Practice Address - Country:US
Practice Address - Phone:682-421-0298
Practice Address - Fax:817-549-5751
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X
TX1098164363LP2300X
TX1094168363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No171W00000XOther Service ProvidersContractor
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care