Provider Demographics
NPI:1942988159
Name:WOLFF, PAYTON MICHELLE (DNP)
Entity Type:Individual
Prefix:
First Name:PAYTON
Middle Name:MICHELLE
Last Name:WOLFF
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 NW 82ND ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-8229
Mailing Address - Country:US
Mailing Address - Phone:816-807-3420
Mailing Address - Fax:
Practice Address - Street 1:502 ROSEPORT ROAD
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:KS
Practice Address - Zip Code:66024
Practice Address - Country:US
Practice Address - Phone:913-348-4453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-82345-022363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health