Provider Demographics
NPI:1285303099
Name:WOLFE, JENI MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:JENI
Middle Name:MARIE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 COLE RD
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-7436
Mailing Address - Country:US
Mailing Address - Phone:307-631-2889
Mailing Address - Fax:
Practice Address - Street 1:2622 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3024
Practice Address - Country:US
Practice Address - Phone:307-631-1380
Practice Address - Fax:307-632-3298
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY48105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily