Provider Demographics
NPI:1518933928
Name:WOLFE, D. MICHAELLE (RPH, CGP)
Entity Type:Individual
Prefix:
First Name:D.
Middle Name:MICHAELLE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:RPH, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 W ESPLANADE AVE
Mailing Address - Street 2:#334
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2551
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5000 W ESPLANADE AVE
Practice Address - Street 2:#334
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2551
Practice Address - Country:US
Practice Address - Phone:504-451-6098
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist