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NPI Code Detail

MEDICARE: JOSHUA MATTHEW WOLF CRNA

MEDICARE:   JOSHUA MATTHEW WOLF  CRNA
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
1367500000XCertified Registered Nurse AnesthetistAP60812176WA
2367500000XCertified Registered Nurse AnesthetistARNP9189812FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2G8044OTHERFLBCBS FLORIDA

General Provider Information

NPI Number : 1649274333
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSHUA MATTHEW WOLF CRNA
Provider Business Mailing Address
First Line : 15570 CASTLEGATE CT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80921-1809
Country : US
Telephone Number : 813-731-9119
Fax Number :
Provider Business Practice Location Address
First Line : 1650 COCHRANE CIR UNIT MEDDAC
Second Line :
City : FORT CARSON
State : CO
Zip : 80913-4604
Country : US
Telephone Number : 719-526-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 07/20/2023

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