Healthcare Provider Details

I. General information

NPI: 1104996503
Provider Name (Legal Business Name): NANCY L WULFF-FERRELL R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25460 MEDICAL CENTER DR SUITE 100
MURRIETA CA
92562-5985
US

IV. Provider business mailing address

25460 MEDICAL CENTER DR SUITE 100
MURRIETA CA
92562-5985
US

V. Phone/Fax

Practice location:
  • Phone: 951-677-4748
  • Fax: 951-677-6529
Mailing address:
  • Phone: 951-677-4748
  • Fax: 951-677-2926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number430485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: