Individual
MS. GLENDA SUE WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
WAMC STOP A, BUILDING 2817 REILLY RD. MCXC COD CS CREDENTIALS, FORT BRAGG, NC 28310-0001
(910) 907-8922
(910) 907-6069
Mailing address
PO BOX 336, RAEFORD, NC 28376-0336
(757) 647-5002
(910) 907-1079
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001134686
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024168543
VA
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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