| Doctor Name: | ANITA RENEE WOOLFORD |
| NPI Number: | 1972920320 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, NP-C |
| License Number: | 19786 |
| Business Practice Address: | 18765 Riverside Drive Vansant, VA - 24656 |
| Business Phone Number: | 2769352880 |
| Business Fax Number: | 2769352889 |
| Mailing Address: | Po Box 924, VANSANT |
| State: | VA |
| Postal Code: | 246560924 |
| Phone Number: | 2769352880 |
| Fax Number: | |
| NPI Enumeration Date: | 03/24/2014 |
| NPI Last Update Date: | 05/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 19786 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |