Provider Demographics
NPI:1336035963
Name:WOLFORD, ESTENE
Entity type:Individual
Prefix:
First Name:ESTENE
Middle Name:
Last Name:WOLFORD
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:SARAH ANN
Mailing Address - State:WV
Mailing Address - Zip Code:25644-0011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 11
Practice Address - Street 2:
Practice Address - City:SARAH ANN
Practice Address - State:WV
Practice Address - Zip Code:25644-0011
Practice Address - Country:US
Practice Address - Phone:304-946-2806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide