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NPI Code Detail

MEDICARE: NICOLE ASHLEY WOLAN RN

MEDICARE: NICOLE ASHLEY WOLAN RN
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
1163WE0003XEmergency Registered NurseRN9386582FL

General Provider Information

NPI Number : 1538965728
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE ASHLEY WOLAN RN
Provider Business Mailing Address
First Line : 5301 BIBLE CAMP RD
Second Line :
City : GROVELAND
State : FL
Zip : 34736-9200
Country : US
Telephone Number : 352-303-5608
Fax Number :
Provider Business Practice Location Address
First Line : 5301 BIBLE CAMP RD
Second Line :
City : GROVELAND
State : FL
Zip : 34736-9200
Country : US
Telephone Number : 352-303-5608
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2025
Last Update Date : 02/20/2025

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