Healthcare Provider Details

I. General information

NPI: 1326675026
Provider Name (Legal Business Name): LYNN SOFIA WOLF CNM, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 FAULCONER DR STE 2D
CHARLOTTESVILLE VA
22903-4980
US

IV. Provider business mailing address

501 FAULCONER DR STE 2D
CHARLOTTESVILLE VA
22903-4980
US

V. Phone/Fax

Practice location:
  • Phone: 434-201-4288
  • Fax: 434-443-3645
Mailing address:
  • Phone: 434-201-4288
  • Fax: 434-443-3645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN11022345
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024179066
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM06288
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024179066
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCNM06288
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: