Healthcare Provider Details

I. General information

NPI: 1962681353
Provider Name (Legal Business Name): DIANE JEANETTE VOELKER M.S., CCC-A, FAAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 E 80TH AVE
MERRILLVILLE IN
46410-5737
US

IV. Provider business mailing address

1609 E 80TH AVE
MERRILLVILLE IN
46410-5737
US

V. Phone/Fax

Practice location:
  • Phone: 219-738-2730
  • Fax: 219-738-2743
Mailing address:
  • Phone: 219-738-2730
  • Fax: 219-738-2743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number23001159A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: