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Individual

MARILYN K WOLPERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
2360 STONY BROOK DR, LOUISVILLE, KY 40220-4018
(502) 446-5462
(502) 394-3670
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3002139
KY
363LF0000X
Family Nurse Practitioner
71001137A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200348470
IN
05
78005659
KY
Enumeration date
06/24/2006
Last updated
01/25/2019
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