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NPI Code Detail

MEDICARE: ALICIA WOLF NP

MEDICARE: ALICIA WOLF NP
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
1363LG0600XGerontology Nurse Practitioner12273MN
2363LG0600XGerontology Nurse PractitionerRN.303147OH
3363LG0600XGerontology Nurse Practitioner08023OH
4363LG0600XGerontology Nurse Practitioner201359ND

General Provider Information

NPI Number : 1639146665
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA WOLF NP
Provider Business Mailing Address
First Line : PO BOX 670486
Second Line :
City : NORTHFIELD
State : OH
Zip : 44067-0486
Country : US
Telephone Number : 440-571-0025
Fax Number : 949-695-3229
Provider Business Practice Location Address
First Line : 100 BROOKMONT RD
Second Line :
City : AKRON
State : OH
Zip : 44333-9207
Country : US
Telephone Number : 440-571-0025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 03/31/2026

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