MEDICARE: KAREN ANN WOLFE 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
1	367500000X	Certified Registered Nurse Anesthetist	R43439	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1831173210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ANN WOLFE CRNA

Provider Business Mailing Address
First Line	:	604 VILLAGGIO DR
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29609-3095
Country	:	US
Telephone Number	:	412-897-3681
Fax Number	:	864-235-6315

Provider Business Practice Location Address
First Line	:	604 VILLAGGIO DR
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29609-3095
Country	:	US
Telephone Number	:	412-897-3681
Fax Number	:	864-235-6315

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	08/13/2008

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