Healthcare Provider Details

I. General information

NPI: 1326173451
Provider Name (Legal Business Name): JEAN MARIE VOLLMER CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 06/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL PLAZA
STAMFORD CT
06904
US

IV. Provider business mailing address

1 HOSPITAL PLAZA BENNETT CANCER CENTER
STAMFORD CT
06904-9317
US

V. Phone/Fax

Practice location:
  • Phone: 203-276-2695
  • Fax: 203-975-7842
Mailing address:
  • Phone: 203-276-2695
  • Fax: 203-975-7842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2207
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: