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General NPI Number Information
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NPI Number | 1053954396
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Entity Type | Individual
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Provider Name | DEBORAH JEAN WOLFORD RN
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Gender | Female
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Dates
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Enumeration Date | 10/18/2019
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Last Update Date | 10/18/2019
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Provider Practice Location Address
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Address Line | 174 MIDWAY BLVD
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City | ELYRIA
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State | OH
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Zip | 44035-2786
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Country | US
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Telephone | 440-723-8995
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Fax |
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Provider Business Mailing Address
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Address Line | 1322 NEW JERSEY AVE
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City | LORAIN
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State | OH
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Zip | 44052-3049
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Country | US
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Telephone | 440-258-3888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | RN.144230
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License Number State | OH
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