Provider Demographics
NPI:1245058270
Name:WOLFE, MORGAN (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2054 SMOKETREE VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-3274
Mailing Address - Country:US
Mailing Address - Phone:530-391-9958
Mailing Address - Fax:
Practice Address - Street 1:1481 W WARM SPRINGS RD STE 136
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7636
Practice Address - Country:US
Practice Address - Phone:530-391-9958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV856968163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty