Individual
STACY LYNN WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN, CDE
Contact information
Practice address
200 WOODLAND PRIME, W126 N7338, MENOMONEE FALLS, WI 53051
(414) 777-5998
Mailing address
200 WOODLAND PRIME, MENOMONEE FALLS, WI 53051-4476
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
21420589
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
400106543
FROEDTERT HEALTH
—
Enumeration date
05/15/2019
Last updated
05/15/2019
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