Individual
JESSICA WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3604 LIVE OAK ST STE 100, DALLAS, TX 75204-6169
(214) 358-2300
Mailing address
PO BOX 660132, DALLAS, TX 75266-0132
(214) 358-2300
(213) 366-6159
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1019042
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019042
NURSES LICENSE
TX
Enumeration date
04/19/2021
Last updated
06/03/2021
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