MEDICARE: GINA WULFF RDN

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	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1366398901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GINA WULFF RDN

Provider Business Mailing Address
First Line	:	4076 NEELY RD.
Second Line	:
City	:	FORT WAINWRIGHT
State	:	AK
Zip	:	99703-1029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4076 NEELY RD.
Second Line	:	UNIT 3
City	:	FORT WAINWRIGHT
State	:	AK
Zip	:	99703
Country	:	US
Telephone Number	:	907-361-5247
Fax Number	:

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

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/12/2026

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