Provider Demographics
NPI:1245402171
Name:WOLF, ERIN E (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:WOLF
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:E
Other - Last Name:MCCORMICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2525 FOX RUN PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-5371
Mailing Address - Country:US
Mailing Address - Phone:605-665-0062
Mailing Address - Fax:605-665-0076
Practice Address - Street 1:301 N 27TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4457
Practice Address - Country:US
Practice Address - Phone:402-844-8110
Practice Address - Fax:402-844-8113
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE262231H00000X
NE086237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025689600Medicaid
NE10025689700Medicaid
NE10025689700Medicaid
NENA1216004Medicare PIN
NE092620001Medicare PIN