Individual provider Active NPI

Sherry Lynne Wolf, RN,MSN,ANP

  • Family Nurse Practitioner
  • Fairbanks, AK
National Provider Identifier
1477958536
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1466 Issued in AK
Practice address
2054 30TH Ave
Fairbanks, AK 99701-7316
Phone
(907) 456-3719
Fax
(907) 456-1511
NPI assigned
Oct 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1466 AK Primary

Addresses

Primary practice location

2054 30TH Ave
Fairbanks, AK 99701-7316

Mailing address

2054 30TH Ave
Fairbanks, AK 99701-7316
Phone (907) 456-3719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1466AKMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1477958536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2054 30TH AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017316",
            "telephone_number": "907-456-3719",
            "fax_number": "907-456-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2054 30TH AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017316",
            "telephone_number": "907-456-3719",
            "fax_number": "907-456-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "SHERRY",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "RN,MSN,ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.