Individual
ROXANNE WOLFRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2500 NILES AVE, SUITE 1, ST. JOSEPH, MI 49085
(269) 983-3380
(269) 983-0353
Mailing address
2500 NILES AVE, SUITE 1, ST. JOSEPH, MI 49085
(269) 983-3380
(269) 983-0353
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28115108A
IN
163W00000X
Registered Nurse
4704168735
MI
363L00000X
Nurse Practitioner
Primary
4704168735
MI
363LF0000X
Family Nurse Practitioner
71000517A
IN
Other
Enumeration date
02/05/2010
Last updated
07/10/2018
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