Provider Demographics
NPI:1790678001
Name:WOLFE, LAUREN KELSEY (FNP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KELSEY
Last Name:WOLFE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 ALBERMARLE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:IN
Mailing Address - Zip Code:46167-8830
Mailing Address - Country:US
Mailing Address - Phone:317-650-5872
Mailing Address - Fax:
Practice Address - Street 1:107 PARK PLACE BLVD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7151
Practice Address - Country:US
Practice Address - Phone:317-272-0708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71016691A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily