Provider Demographics
NPI:1558353730
Name:WOLF, ANN M (ARNP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:WOLF
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:SCHUSTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-3406
Mailing Address - Fax:319-356-8378
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-3406
Practice Address - Fax:319-356-8378
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF081814363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0445437Medicaid
IA37490OtherWELLMARCK BCBS
IAI13169Medicare PIN
IAP00709672Medicare PIN
P27385Medicare UPIN