Shelly Evelyn Wolfrom, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704251002 Issued in MI

Practice address

781 36TH St SE
Grand Rapids, MI 49548-2319

Phone

(616) 248-5163

Fax

(616) 243-2302

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780736637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 141",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495010141",
            "telephone_number": "616-248-5163",
            "fax_number": "616-243-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 36TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495482319",
            "telephone_number": "616-248-5163",
            "fax_number": "616-243-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFROM",
        "first_name": "SHELLY",
        "middle_name": "EVELYN",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704251002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Paul Wolff, PSYD
• Andrea L Wolffis
• Debra Marie Wolffis, LPC, NCC
• Jennifer Wolffis, PT
• Haley Ann Wolfgram, LMSW
• Jeffrey Alan Wolfson, M.D.
• Seth W Wolk, M.D.
• Kali Jo Wolken, LMHC, LPC
• Marli Wollet
• John Wolohan

• All providers in Grand Rapids, MI
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.