Individual
MICHAEL TODD WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1050 DIVISION ST, MAUSTON, WI 53948
(608) 847-6161
Mailing address
1050 DIVISION ST, MAUSTON, WI 53948-1931
(608) 847-6161
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2440-33
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
2440-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43347500
—
WI
Enumeration date
09/19/2005
Last updated
11/08/2019
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