Provider Demographics
NPI:1548408826
Name:WOLFER, DENISE NANETTE (PROFESSIONAL FP)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:NANETTE
Last Name:WOLFER
Suffix:
Gender:F
Credentials:PROFESSIONAL FP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 N. 19TH AVENUE, SUITE 310
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85315
Mailing Address - Country:US
Mailing Address - Phone:602-433-1344
Mailing Address - Fax:602-249-1570
Practice Address - Street 1:5501 N 19TH AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2450
Practice Address - Country:US
Practice Address - Phone:602-433-1344
Practice Address - Fax:602-249-1570
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1164636174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist