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General NPI Number Information
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NPI Number | 1548713993
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Entity Type | Organization
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Legal Business Name | SHARA WOLFE FNP
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 1322 N ACADEMY BLVD STE. 204
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-3317
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Country | US
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Telephone | 719-638-8844
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Fax | 719-638-8115
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Provider Business Mailing Address
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Address Line | PO BOX 76510
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City | COLORADO SPRINGS
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State | CO
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Zip | 80970-6510
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Country | US
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Telephone | 719-638-8844
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Fax | 719-638-8115
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Authorized Official
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Title or Position | OWNER
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Name | SHARA WOLFE
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Credential | FNP
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Telephone | 719-761-4733
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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 | APN.0991288-NP
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License Number State | CO
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