Healthcare Provider Details

I. General information

NPI: 1871485144
Provider Name (Legal Business Name): LYNDA WOLFE APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 OAKDALE AVE N
ROBBINSDALE MN
55422
US

IV. Provider business mailing address

3300 OAKDALE AVE N
ROBBINSDALE MN
55422
US

V. Phone/Fax

Practice location:
  • Phone: 763-581-3700
  • Fax: 763-581-3701
Mailing address:
  • Phone: 763-581-3700
  • Fax: 763-581-3701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number13109
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: