Provider Demographics
NPI:1831814003
Name:WOLF, AMY KATHRYN (RN BSN CPN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:KATHRYN
Last Name:WOLF
Suffix:
Gender:F
Credentials:RN BSN CPN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:KATHRYN
Other - Last Name:DESIDERIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN BSN
Mailing Address - Street 1:201 NEW ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1140
Mailing Address - Country:US
Mailing Address - Phone:302-378-5027
Mailing Address - Fax:302-378-5080
Practice Address - Street 1:201 NEW ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1140
Practice Address - Country:US
Practice Address - Phone:302-378-5027
Practice Address - Fax:302-378-5080
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0032650163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool