MR. KELLY LEWIS WOOLSON LPN NPI 1215154968

NPI Information

  • NPI: 1215154968
  • Provider Name: MR. KELLY LEWIS WOOLSON, LPN
  • Classification: Licensed Practical Nurse - 164W00000X
  • Entity Type: Individual
  • Address: 146 SHORE OAKS DR
    OSWEGO, NY
    ZIP 13126
  • Phone: (315) 343-0370

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NPI Details

MR. Kelly Lewis Woolson, LPN is a licensed practical nurse in Oswego, NY. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. MR. Kelly Lewis Woolson, LPN NPI is 1215154968. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

146 SHORE OAKS DR
OSWEGO, NY
ZIP 13126-230
Phone: (315) 343-0370

The enumeration date for this NPI number is 4/20/2007 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1164W00000XLicensed Practical Nurse245024NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
101826324MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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