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General NPI Number Information
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NPI Number | 1659427607
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Entity Type | Individual
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Provider Name | COLLEEN DASCHBACH WOLFORD FNP
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Gender | Female
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 987 SAINT SEBASTIAN WAY
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City | AUGUSTA
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State | GA
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Zip | 30912-5741
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Country | US
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Telephone | 706-721-3448
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Fax |
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Provider Business Mailing Address
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Address Line | 426 GEMSTONE CT
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City | EVANS
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State | GA
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Zip | 30809-6055
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Country | US
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Telephone | 706-787-9122
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Fax | 706-787-9116
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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 | APRN229848
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License Number State | GA
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