Provider Demographics
NPI:1194908764
Name:WOLFF, KARRAN KIRKLE (RN)
Entity type:Individual
Prefix:MS
First Name:KARRAN
Middle Name:KIRKLE
Last Name:WOLFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 SCENIC DRIVE BLDG 3
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95353-3127
Mailing Address - Country:US
Mailing Address - Phone:209-652-1955
Mailing Address - Fax:
Practice Address - Street 1:830 SCENIC DRIVE BLDG 3
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95353-3127
Practice Address - Country:US
Practice Address - Phone:209-652-1955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN166623171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator