Provider Demographics
NPI:1710421243
Name:WOLFE, SUNSHINE MIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:SUNSHINE
Middle Name:MIA
Last Name:WOLFE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1930 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-1859
Practice Address - Country:US
Practice Address - Phone:317-838-3596
Practice Address - Fax:317-268-0071
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006842A363LF0000X
IN28178782A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily