1013007723 NPI number — WANEDA KAY WOLFE M.N., C.N.S., A.N.P.

NPI Number: 1013007723
Health Care Provider/Practitioner: WANEDA KAY WOLFE M.N., C.N.S., A.N.P.

NPI Number : 1013007723 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1013007723",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WOLFE",
    "FirstName": "WANEDA",
    "MiddleName": "KAY",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "M.N., C.N.S., A.N.P.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 913",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PANAMA CITY",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32402-0913",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "850-814-8400",
    "MailingAddressFaxNumber": "850-215-8405",
    "FirstLinePracticeLocationAddress": "100 DOCTORS DR STE C",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PANAMA CITY",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32405-7609",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "850-814-8400",
    "PracticeLocationAddressFaxNumber": "850-215-8405",
    "EnumerationDate": "10/13/2006",
    "LastUpdateDate": "03/16/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363LA2200X",
          "TaxonomyName": "Adult Health Nurse Practitioner",
          "LicenseNumber": "ARNP3417872",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "364SP0812X",
          "TaxonomyName": "Community Psychiatric/Mental Health Clinical Nurse Specialist",
          "LicenseNumber": "ARNP3417872",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}