Individual
MS. KIM MARIE WOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
13800 W MARIA DR, NEW BERLIN, WI 53151-6889
(414) 529-4378
Mailing address
13800 W MARIA DR, NEW BERLIN, WI 53151-6889
(414) 630-7156
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
966-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366603581
—
WI
Enumeration date
06/20/2008
Last updated
12/31/2018
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