Mary Ann Wolfenson, RN, DNP

Individual provider Active NPI Community Health Registered Nurse · Phoenix, AZ

NPI 1770170045 · NPPES record last updated Dec 21, 2020

Key facts

NPI
1770170045
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
041197834 (IL)
Practice address
4650 N Central Ave Unit 174
Phoenix, AZ 85012-1072
Phone
(708) 925-2502
NPI assigned
Dec 21, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041197834ILMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 041197834 IL Yes

Addresses

Primary practice location

4650 N Central Ave Unit 174
Phoenix, AZ 85012-1072

Mailing address

4650 N Central Ave
Phoenix, AZ 85012-1068
Phone (708) 925-2502

Other providers in Phoenix, AZ

All providers in Phoenix, AZ · Community Health Registered Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.