Provider Demographics
NPI:1023486016
Name:WOLF, RICKAY MARIE (APRN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:RICKAY
Middle Name:MARIE
Last Name:WOLF
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:623 N COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-2555
Mailing Address - Country:US
Mailing Address - Phone:307-363-5930
Mailing Address - Fax:888-720-0569
Practice Address - Street 1:623 N COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-2555
Practice Address - Country:US
Practice Address - Phone:307-363-5930
Practice Address - Fax:888-720-0569
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY35906163W00000X
WY49878363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse