MEDICARE: LYNNE A. WOLFE CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	R18721	MD
2	363LP0200X	Pediatric Nurse Practitioner	R18721	MD

General Provider Information

NPI Number	:	1356347017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE A. WOLFE CRNP

Provider Business Mailing Address
First Line	:	2014 BALTIMORE RD APT H34
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20851-1267
Country	:	US
Telephone Number	:	203-687-7288
Fax Number	:

Provider Business Practice Location Address
First Line	:	NIH NHGRI BLDG 10 10 CENTER DR
Second Line	:	RM 3-2551, MSC 1205
City	:	BETHESDA
State	:	MD
Zip	:	20892-0001
Country	:	US
Telephone Number	:	301-443-8577
Fax Number	:	301-496-7157

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	01/28/2010

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