Individual
JUDITH A WULF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
401 PHALEN BOULEVARD, ST. PAUL, MN 55130-5302
(651) 254-7900
(651) 254-7904
Mailing address
PO BOX 1309 - 8170 33RD AVE S, MAIL STOP 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 254-7900
(651) 254-7904
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP2302
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-10205
MEDICA
MN
05
—
1184698557
—
MN
05
—
43917100
—
WI
Enumeration date
02/14/2006
Last updated
10/01/2015
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