MEDICARE: DANA J. WOLFE FNP

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	363L00000X	Nurse Practitioner	5005008	NC
2	363LF0000X	Family Nurse Practitioner	5005008	NC

General Provider Information

NPI Number	:	1053413773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA J. WOLFE FNP

Provider Business Mailing Address
First Line	:	PO BOX 19305
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28219-9305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10210 COULOAK DR
Second Line	:	STE E
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-7679
Country	:	US
Telephone Number	:	704-801-2000
Fax Number	:

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

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	07/15/2024

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