Provider Demographics
NPI:1396475299
Name:WOLFE, STEPHANIE KATHERYN
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KATHERYN
Last Name:WOLFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25350 ROCKSIDE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-7111
Mailing Address - Country:US
Mailing Address - Phone:216-961-8804
Mailing Address - Fax:440-374-4965
Practice Address - Street 1:25350 ROCKSIDE RD STE 100
Practice Address - Street 2:
Practice Address - City:BEDFORD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44146-7111
Practice Address - Country:US
Practice Address - Phone:216-961-8804
Practice Address - Fax:440-374-4965
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.324146163WX0003X
OHAPRN.CNP.0032238363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient