Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | ARNP3417872 | FL |
NPI | 1013007723 |
---|---|
Provider Name | Ms. Waneda Kay Wolfe |
First Address | Panama City, FL 32402-0913 |
Second Address | Panama City, FL 32405-7609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 16/03/2010 |