Healthcare Provider Details
I. General information
NPI: 1730148602
Provider Name (Legal Business Name): GEORGE PATRICK WOLFE JR. CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/21/2006
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21800 LIBBY RD
MAPLE HEIGHTS OH
44137-2947
US
IV. Provider business mailing address
102 WOODMONT BLVD STE 600
NASHVILLE TN
37205-5250
US
V. Phone/Fax
- Phone: 330-388-0339
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | NP07411 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | NP07411 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: