Healthcare Provider Details

I. General information

NPI: 1326951252
Provider Name (Legal Business Name): LYDIA WOLF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 19TH ST NW STE 800
WASHINGTON DC
20036-3676
US

IV. Provider business mailing address

2710 BELLFOREST CT APT 106
VIENNA VA
22180-7333
US

V. Phone/Fax

Practice location:
  • Phone: 202-844-2026
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License NumberRN500014942
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number0001319246
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: