Individual
JENNIE ANNA WOLFRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6720 BERTNER AVE, HOUSTON, TX 77030-2604
(832) 355-2666
Mailing address
6501 FANNIN ST STE NC114, HOUSTON, TX 77030-2703
(713) 798-7356
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
280657
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP119481
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
591783920
CHAMPUS
—
01
—
G2063
BC/BS FL
FL
01
—
P00077130
RAILROAD MEDICARE
—
Enumeration date
02/16/2006
Last updated
09/07/2023
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