Healthcare Provider Details

I. General information

NPI: 1285325217
Provider Name (Legal Business Name): APRIL M WOLFE LDO 2264
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 GLENN SCHOOL RD
DURHAM NC
27704-3515
US

IV. Provider business mailing address

1927 CHAMBERS LOOP RD
TIMBERLAKE NC
27583-7455
US

V. Phone/Fax

Practice location:
  • Phone: 919-688-3259
  • Fax:
Mailing address:
  • Phone: 740-739-8311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number2264
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: