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NPI 1407578396

NPI 1407578396 : CHRISTIN TAYLOR WOLFRAM NP : CENTERVILLE, OH

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General NPI Number Information
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    NPI Number           |    1407578396
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTIN TAYLOR WOLFRAM NP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/16/2022
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    Last Update Date     |    12/01/2025
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Provider Practice Location Address
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    Address Line         |    101 E ALEX BELL RD STE 190 
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    City                 |    CENTERVILLE
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    State                |    OH
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    Zip                  |    45459-2752
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    Country              |    US
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    Telephone            |    937-425-4030
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    Fax                  |    937-425-4039
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Provider Business Mailing Address
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    Address Line         |    1 PRESTIGE PL STE 550 
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    City                 |    MIAMISBURG
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    State                |    OH
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    Zip                  |    45342-6115
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    Country              |    US
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    Telephone            |    937-762-1306
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    Fax                  |    937-522-7017
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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        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    0024178073
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    License Number State |    VA
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