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Individual

KALLI M WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CMW

Contact information

Practice address
2104 BANBURY LN, OKLAHOMA CITY, OK 73170-3401
(405) 203-5382
Mailing address
2104 BANBURY LN, OKLAHOMA CITY, OK 73170-3401
(405) 203-5382

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
121796
OK
367A00000X
Advanced Practice Midwife
CNM04688

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200776420A
OK
Enumeration date
01/10/2018
Last updated
08/26/2021
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