Provider Demographics
NPI:1629291471
Name:WOLFE, MAUREEN OLIVE (RN)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:OLIVE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1398
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95436-1398
Mailing Address - Country:US
Mailing Address - Phone:707-887-2838
Mailing Address - Fax:
Practice Address - Street 1:19375 HWY 116
Practice Address - Street 2:19375 HIGHWAY 116
Practice Address - City:MONTE RIO
Practice Address - State:CA
Practice Address - Zip Code:95462-0519
Practice Address - Country:US
Practice Address - Phone:707-865-1200
Practice Address - Fax:707-865-3151
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 447673163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health