Provider Demographics
NPI:1760615488
Name:WOLFE, ERIN J (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:J
Last Name:WOLFE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:J
Other - Last Name:TEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNC-OB, BSN
Mailing Address - Street 1:21 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1133
Mailing Address - Country:US
Mailing Address - Phone:321-841-5560
Mailing Address - Fax:407-425-5947
Practice Address - Street 1:21 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1133
Practice Address - Country:US
Practice Address - Phone:321-841-5560
Practice Address - Fax:407-425-5947
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN149352363LW0102X
FLARNP9320201363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGS131ZMedicare PIN