Provider Demographics
NPI:1962680850
Name:WOLFINGER, ELIZABETH A (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:WOLFINGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:1000 NORLAND AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4229
Practice Address - Country:US
Practice Address - Phone:717-267-6363
Practice Address - Fax:717-839-6421
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001185734163W00000X
MDR203644363L00000X
VA0024167802363L00000X
PASP012457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11820034OtherCAQH
PA103639775Medicaid
VA1962680850Medicaid