Jacquelyn Marie Wooldridge, CNS

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

2000174217 Issued in MO

Practice address

3901 E 32ND St
Joplin, MO 64804-3312

Phone

(417) 347-7540

Fax

(417) 347-7549

NPI assigned

Oct 3, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1972697696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2526",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648032526",
            "telephone_number": "417-347-7540",
            "fax_number": "417-347-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 E 32ND ST",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043312",
            "telephone_number": "417-347-7540",
            "fax_number": "417-347-7549"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 N Washington St",
            "address_purpose": "LOCATION",
            "city": "Neosho",
            "state": "MO",
            "postal_code": "648501521",
            "country_code": "US",
            "telephone_number": "417-347-7840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOLDRIDGE",
        "first_name": "JACQUELYN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MO",
            "license": "2000174217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425193406",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ray K. Woodmansee, MD
• Morgan L Woods, MSW
• Benjamin Warren Woodson, M.D.
• Jaime Woodward
• Jeffrey A Wool, M.D.
• Kayla Wooldridge, D.O.
• Minette Jane Woolven
• Workplace Medical Center, LLC
• Richard C. Worley, CRNA
• Breanna R Worstell

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Joplin, MO
• Providers in Joplin, MO by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.