Jeffrey Alan Wolff, AGAC-NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704292956 Issued in MI

Practice address

2065 Edward LN E
Kimball, MI 48074-1925

Phone

(586) 260-6154

NPI assigned

Oct 16, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1841701034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 EDWARD LN E",
            "city": "KIMBALL",
            "state": "MI",
            "postal_code": "480741925",
            "telephone_number": "586-260-6154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 EDWARD LN E",
            "city": "KIMBALL",
            "state": "MI",
            "postal_code": "480741925",
            "telephone_number": "586-260-6154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3990 John R St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012018",
            "country_code": "US",
            "telephone_number": "313-745-8040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "AGAC-NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-16",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704292956",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704292956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Crystal M Vollstaedt, LPN
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• Kelley Wood, BSN,RN
• Woodward Detroit CVS, L.L.C.

• Acute Care Nurse Practitioner in Kimball, MI
• Providers in Kimball, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.