Provider Demographics
NPI:1609000454
Name:WOLFE, NICOLE SUZETTE (CNP-F)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:SUZETTE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:CNP-F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 HIEBER RD
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-9305
Mailing Address - Country:US
Mailing Address - Phone:419-561-0193
Mailing Address - Fax:
Practice Address - Street 1:3710 HIEBER RD
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-9305
Practice Address - Country:US
Practice Address - Phone:419-561-0193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN332536163W00000X
OHCOA.17025-NP363LF0000X
OHAPRN.CNP.17025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse