Provider Demographics
NPI:1740799808
Name:WOLFE, JULIA ROGERS (NP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ROGERS
Last Name:WOLFE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:960 MASSACHUSETTS AVENUE
Mailing Address - Street 2:FL 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:930 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1274
Practice Address - Country:US
Practice Address - Phone:617-414-6800
Practice Address - Fax:617-414-6817
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2023-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN2310372363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110129134AMedicaid