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General NPI Number Information
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NPI Number | 1184698557
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Entity Type | Individual
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Provider Name | JUDITH A WULF ANP
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Gender | Female
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 401 PHALEN BOULEVARD
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City | ST. PAUL
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State | MN
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Zip | 55130-5302
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Country | US
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Telephone | 651-254-7900
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Fax | 651-254-7904
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Provider Business Mailing Address
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Address Line | PO BOX 1309 - 8170 33RD AVE S MAIL STOP 21110Q
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City | MINNEAPOLIS
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State | MN
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Zip | 55425-4516
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Country | US
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Telephone | 651-254-7900
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Fax | 651-254-7904
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CNP2302
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License Number State | MN
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