Provider Demographics
NPI:1417568213
Name:WOLFE, LOVINE
Entity type:Individual
Prefix:
First Name:LOVINE
Middle Name:
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 1:5076 WELTON ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26847-8176
Mailing Address - Country:US
Mailing Address - Phone:304-703-3961
Mailing Address - Fax:
Practice Address - Street 1:70 RIO GRANDE RD
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26847-4503
Practice Address - Country:US
Practice Address - Phone:304-257-7756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker