Individual
COURTNEY E WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
28154359
IN
363LN0000X
Neonatal Nurse Practitioner
Primary
71002062A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000589162
ANTHEM PROVIDER NUMBER
IN
05
—
200515470
—
IN
01
—
P01221391
RR MEDICARE PTAN
IN
Enumeration date
10/24/2006
Last updated
04/03/2024
Update your record
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