Provider Demographics
NPI:1093862732
Name:WOLFSON, APRIL LETA (RN, CNP)
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:LETA
Last Name:WOLFSON
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:MISS
Other - First Name:APRIL
Other - Middle Name:LETA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, MN, PMH-NP
Mailing Address - Street 1:327 MARSCHALL RD # 350
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-1687
Mailing Address - Country:US
Mailing Address - Phone:651-769-6500
Mailing Address - Fax:
Practice Address - Street 1:327 MARSCHALL RD # 350
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-1687
Practice Address - Country:US
Practice Address - Phone:651-769-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1919802163WP0809X
MN2084363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9651746Medicaid
WA9651746Medicaid