MEDICARE: RHONDA MARIE WOLFE MSN

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
1	363LF0000X	Family Nurse Practitioner	R1518546	MN

Other Identifiers

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

General Provider Information

NPI Number	:	1043204647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RHONDA MARIE WOLFE MSN

Provider Business Mailing Address
First Line	:	6300 WEDGWOOD RD N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-3647
Country	:	US
Telephone Number	:	651-773-4958
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 WEDGWOOD RD N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-3647
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	12/02/2020

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