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Individual

ELLEN S DEWOLFE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN PC

Taxonomy

Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
RN16128
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000098073
BC/BS
MT
05
4300153
MT
01
890000386
RAILROAD MEDICARE
MT
Enumeration date
08/22/2006
Last updated
10/10/2019
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