Provider Demographics
NPI:1457646366
Name:WOLFE, HEIDI LOUISE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:LOUISE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 WYNNEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-1776
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2710 SAINT FRANCIS DR STE 101
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5633
Practice Address - Country:US
Practice Address - Phone:319-272-5700
Practice Address - Fax:319-272-0188
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist