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General NPI Number Information
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NPI Number | 1578159752
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Entity Type | Individual
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Provider Name | NICOLE JOHANN WOLFF FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/12/2020
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 3083 FORT AMANDA RD
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City | LIMA
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State | OH
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Zip | 45805-3834
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Country | US
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Telephone | 419-236-7849
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Fax |
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Provider Business Mailing Address
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Address Line | 3083 FORT AMANDA RD
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City | LIMA
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State | OH
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Zip | 45805-3834
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Country | US
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Telephone | 419-236-7849
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F11200756
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License Number State | OH
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