Provider Demographics
NPI:1518018324
Name:WOLF, JACALINE (CRNP)
Entity type:Individual
Prefix:
First Name:JACALINE
Middle Name:
Last Name:WOLF
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2211
Mailing Address - Country:US
Mailing Address - Phone:610-965-1900
Mailing Address - Fax:610-965-2900
Practice Address - Street 1:730 HARRISON ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-2211
Practice Address - Country:US
Practice Address - Phone:610-965-1900
Practice Address - Fax:610-965-2900
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009164363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP009164OtherLICENSE