Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN081813 | AZ |
NPI | 1053345090 |
---|---|
Provider Name | Ms. Suzanne Oko Wolf |
First Address | Westhampton, MA 01027-9542 |
Second Address | Leeds, MA 01053-9764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 30/07/2010 |