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General NPI Number Information
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NPI Number | 1811319437
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Entity Type | Individual
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Provider Name | RANDY WOLFE RNP
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Gender | Male
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Dates
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Enumeration Date | 01/16/2014
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Last Update Date | 04/03/2014
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Provider Practice Location Address
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Address Line | 593 EDDY ST APC4
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City | PROVIDENCE
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State | RI
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Zip | 02903-4923
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Country | US
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Telephone | 401-272-1800
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Fax | 401-435-7069
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Provider Business Mailing Address
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Address Line | PO BOX 16149
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City | RUMFORD
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State | RI
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Zip | 02916-0697
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Country | US
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Telephone | 401-453-9625
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Fax | 401-435-7069
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NPP37855
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License Number State | RI
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