Provider Demographics
NPI:1407458094
Name:WOLFORD, RONDA J
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:J
Last Name:WOLFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 SWANS RD NE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-8840
Mailing Address - Country:US
Mailing Address - Phone:740-334-9512
Mailing Address - Fax:
Practice Address - Street 1:711 SWANS RD NE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-8840
Practice Address - Country:US
Practice Address - Phone:740-334-9512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker