Healthcare Provider Details

I. General information

NPI: 1164768040
Provider Name (Legal Business Name): KAYLA WOLFE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2012
Last Update Date: 12/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26191 JOHN J WILLIAMS HWY
MILLSBORO DE
19966-4950
US

IV. Provider business mailing address

26191 JOHN J WILLIAMS HWY
MILLSBORO DE
19966-4950
US

V. Phone/Fax

Practice location:
  • Phone: 302-945-6060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP447348
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0004355
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: