Provider Demographics
NPI:1467562074
Name:WOLFE, LAURA ESTHER (CRNP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ESTHER
Last Name:WOLFE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:SCHNEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 SPRING HOLLOW LANE
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17915
Mailing Address - Country:US
Mailing Address - Phone:570-389-4451
Mailing Address - Fax:570-389-3417
Practice Address - Street 1:400 E 2ND ST
Practice Address - Street 2:BLOOMSBURG UNIVERSITY, KUB 324
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-1301
Practice Address - Country:US
Practice Address - Phone:570-389-4451
Practice Address - Fax:570-389-3417
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN336219L163W00000X
PASP007383363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA004991OtherCRNP