Provider Demographics
NPI:1841526316
Name:WOLFE, C. RENEE WORRELL (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:C. RENEE
Middle Name:WORRELL
Last Name:WOLFE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 AIRPORT BLVD NW
Mailing Address - Street 2:SUITE F
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-8674
Mailing Address - Country:US
Mailing Address - Phone:252-206-5622
Mailing Address - Fax:252-206-5623
Practice Address - Street 1:3520 AIRPORT BLVD NW
Practice Address - Street 2:SUITE F
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-8674
Practice Address - Country:US
Practice Address - Phone:252-206-5622
Practice Address - Fax:252-206-5623
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC147127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily