Healthcare Provider Details

I. General information

NPI: 1831035120
Provider Name (Legal Business Name): PEGGY SUE WOLF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 BACH BUXTON RD
BATAVIA OH
45103-2897
US

IV. Provider business mailing address

4101 BACH BUXTON RD
BATAVIA OH
45103-2897
US

V. Phone/Fax

Practice location:
  • Phone: 513-947-7600
  • Fax: 513-752-3460
Mailing address:
  • Phone: 513-947-7600
  • Fax: 513-752-3460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number444644
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: