Individual
MRS. CARLENE MAYNOR WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1208 OFFICE PARK DR, OXFORD, MS 38655-3597
(662) 234-9888
Mailing address
2020 EXETER RD, GERMANTOWN, TN 38138-3945
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R764119
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00113694
—
MS
05
—
08184344
—
MS
Enumeration date
10/04/2006
Last updated
09/19/2022
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