Individual
ASHLEY LAUREN WOLFGANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2598 W WHITE RIVER BLVD, MUNCIE, IN 47303-5251
(765) 747-3888
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002122A
IN
363AS0400X
Surgical Physician Assistant
10002122
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001154832
ANTHEM
IN
01
—
10002122A
LICENSE
IN
05
—
300012382
—
IN
Enumeration date
05/31/2016
Last updated
03/30/2026
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