Provider Demographics
NPI:1013283845
Name:LAWRENCE-WOLFF, KATRINA MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:MARIE
Last Name:LAWRENCE-WOLFF
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:MARIE
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3537 W FRONT ST STE A
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7942
Mailing Address - Country:US
Mailing Address - Phone:231-935-8330
Mailing Address - Fax:231-935-3437
Practice Address - Street 1:3537 W FRONT ST STE A
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7942
Practice Address - Country:US
Practice Address - Phone:231-935-8330
Practice Address - Fax:231-935-3437
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004360A207R00000X, 207RR0500X
MI5101026699207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine