Individual ProviderTheresa P WoolbrightNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1 Lincoln Pkwy Ste 202, Hattiesburg, MS 39402-3261(601) 288-8050PECOS EnrollmentBased on the most recent information from CMS, provider Theresa P Woolbright does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1154351815Provider TypeIndividualFull NameWoolbright, Theresa PCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date7/5/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address1 Lincoln Pkwy Ste 202, Hattiesburg, MS 39402-3261Phone(601) 288-8050FaxUnlisted FaxMailing LocationMailing Address1 Lincoln Pkwy Ste 202, Hattiesburg, MS 39402-3261Phone(601) 288-8050FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR541265MississippiProvider IdentifiersIDDescriptionIssuerID500011980DescriptionOtherIssuerMEDICARE RAILROADMississippiID06606224DescriptionMedicaidIssuerUnlistedMississippi