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Individual

MRS. HEATHER R WOLF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1470 12TH STREET, FENNIMORE, WI 53809
(608) 822-3367
Mailing address
1470 12TH STREET, FENNIMORE, WI 53809
(608) 822-3367

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
35044800
WI
Enumeration date
02/08/2008
Last updated
02/08/2008
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