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NPI Code Detail

MEDICARE: MRS. TERESA LYNN WOLFE PA

MEDICARE: MRS. TERESA LYNN WOLFE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant9419MN
2363AM0700XMedical Physician Assistant5640WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003889817
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERESA LYNN WOLFE PA
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 451 JUNCTION RD
Second Line :
City : MADISON
State : WI
Zip : 53717-2656
Country : US
Telephone Number : 608-265-7670
Fax Number : 608-265-7739
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2006
Last Update Date : 03/08/2022

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