Provider Demographics
NPI:1073592846
Name:WOLFE, MARGUERITE M (CRNA)
Entity Type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:M
Last Name:WOLFE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7017 MEGAN LN
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3013
Mailing Address - Country:US
Mailing Address - Phone:301-474-4896
Mailing Address - Fax:301-474-5021
Practice Address - Street 1:7017 MEGAN LN
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3013
Practice Address - Country:US
Practice Address - Phone:301-474-4896
Practice Address - Fax:301-474-5021
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR042915367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD017447S50Medicare PIN