Provider Demographics
NPI:1154768844
Name:WOLFF, DIANE MAURINE (RN)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:MAURINE
Last Name:WOLFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:MAURINE
Other - Last Name:TESCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 CARE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-5054
Mailing Address - Country:US
Mailing Address - Phone:517-439-9327
Mailing Address - Fax:517-439-3339
Practice Address - Street 1:25 CARE DR
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-5054
Practice Address - Country:US
Practice Address - Phone:517-439-9327
Practice Address - Fax:517-439-3339
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704249374163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse