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General NPI Number Information
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NPI Number | 1285830182
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Entity Type | Individual
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Provider Name | JULIE ANN WOLTER CNS
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Gender | Female
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 04/27/2025
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Provider Practice Location Address
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Address Line | 110 1ST ST E
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City | JORDAN
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State | MN
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Zip | 55352-1502
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Country | US
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Telephone | 952-856-0522
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Fax |
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Provider Business Mailing Address
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Address Line | 981 WOODVIEW CIR
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City | CARVER
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State | MN
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Zip | 55315-4519
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Country | US
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Telephone | 651-402-3648
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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 | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 102
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | R 153123-5
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License Number State | MN
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