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NPI Code Detail

MEDICARE: MRS. SUSAN M WOLF CRNP

MEDICARE: MRS. SUSAN M WOLF CRNP
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
1363LF0000XFamily Nurse PractitionerTP005838BPA

General Provider Information

NPI Number : 1245230499
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN M WOLF CRNP
Provider Business Mailing Address
First Line : 620 SPEAR ST
Second Line :
City : OXFORD
State : PA
Zip : 19363-1655
Country : US
Telephone Number : 610-932-9300
Fax Number : 610-932-5283
Provider Business Practice Location Address
First Line : 620 SPEAR ST
Second Line :
City : OXFORD
State : PA
Zip : 19363-1655
Country : US
Telephone Number : 610-932-9300
Fax Number : 610-932-5283
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 02/25/2013

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