Provider Demographics
NPI:1720446230
Name:WOLFE, JENNY MARIE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:MARIE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7940 STEVEN FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2065
Mailing Address - Country:US
Mailing Address - Phone:731-336-7080
Mailing Address - Fax:
Practice Address - Street 1:2170 S GERMANTOWN RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3804
Practice Address - Country:US
Practice Address - Phone:901-516-6799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000020477363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily