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General NPI Number Information
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NPI Number | 1912415068
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Entity Type | Individual
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Provider Name | ERICA JANE WOLF
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Gender | Female
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 3101 BURNET AVE
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City | CINCINNATI
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State | OH
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Zip | 45229-3014
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Country | US
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Telephone | 859-802-0759
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Fax |
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Provider Business Mailing Address
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Address Line | 3737 SOUTHERN BLVD STE 4200
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City | KETTERING
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State | OH
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Zip | 45429-0135
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Country | US
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Telephone | 937-294-1489
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Fax | 937-294-7999
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | RN.425121
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.024338
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License Number State | OH
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