Provider Demographics
NPI:1538743877
Name:WOLF, MEGAN BROOKE (FNP-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:BROOKE
Last Name:WOLF
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:BROOKE
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:6002 BEAVER CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022
Mailing Address - Country:US
Mailing Address - Phone:770-910-5171
Mailing Address - Fax:
Practice Address - Street 1:993 JOHNSON FY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-256-1727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN268612363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily