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Individual

ALISE WOLFGANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP-BC

Contact information

Practice address
1100 WALNUT ST, 5TH FLOOR MOB, PHILADELPHIA, PA 19107-5563
(215) 503-7326
(215) 503-7577
Mailing address
1100 WALNUT ST, 5TH FLOOR MOB, PHILADELPHIA, PA 19107-5563
(215) 503-7326
(215) 503-7577

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP009379
PA

Other

Enumeration date
05/29/2008
Last updated
12/31/2013
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