Dwan Siggers Wolfe, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R785196 Issued in MS

Practice address

1500 E. Woodrow Wilson Drive
Primary Care Blue II Clinic
Jackson, MS 39216-5199

Phone

(601) 362-4471

Fax

(601) 368-3917

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dwan Siggers Wolfe Other name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1780783373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E. WOODROW WILSON DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165199",
            "telephone_number": "601-362-4471",
            "fax_number": "601-368-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E. WOODROW WILSON DRIVE",
            "address_2": "PRIMARY CARE BLUE II CLINIC",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165199",
            "telephone_number": "601-362-4471",
            "fax_number": "601-368-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "DWAN",
        "middle_name": "SIGGERS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R785196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DWAN",
            "last_name": "WOLFE",
            "middle_name": "SIGGERS",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John D Wofford Jr., M.D.
• John David Wofford III, MD
• Marion R. Wofford, MD
• Ryan Edward Wolf, MD
• Douglas A Wolfe, M.D.
• Jimmy V Wolfe, M.D.
• Lloyd B. Wolfe Jr., D.M.D.
• Olivia Wolfe
• Candice Magee Wolken, LPTA
• Emma Womack

• Family Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.