Healthcare Provider Details

I. General information

NPI: 1639992480
Provider Name (Legal Business Name): CATHERINE ANN WOLF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CATHERINE ANN BELCHER

II. Dates (important events)

Enumeration Date: 10/31/2024
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7916 W RYGATE CT
BOISE ID
83714-6806
US

IV. Provider business mailing address

7916 W RYGATE CT
BOISE ID
83714-6806
US

V. Phone/Fax

Practice location:
  • Phone: 208-409-6805
  • Fax:
Mailing address:
  • Phone: 208-409-6805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberN-34563
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: