MEDICARE: DEBRA L WOLF RN, CNP

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	363LP0200X	Pediatric Nurse Practitioner	COA.12106-NP	OH
2	363L00000X	Nurse Practitioner	APRN.CNP.12106	OH
3	363LF0000X	Family Nurse Practitioner	COA.12106-NP	OH

General Provider Information

NPI Number	:	1487772588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA L WOLF RN, CNP

Provider Business Mailing Address
First Line	:	3333 BURNET AVE.
Second Line	:	ML 2001
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3039
Country	:	US
Telephone Number	:	513-636-4408
Fax Number	:	513-636-7337

Provider Business Practice Location Address
First Line	:	3333 BURNET AVE.
Second Line	:	ML 2001
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3039
Country	:	US
Telephone Number	:	513-636-4408
Fax Number	:	513-636-7337

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

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	06/10/2026

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