Healthcare Provider Details

I. General information

NPI: 1679485460
Provider Name (Legal Business Name): JENA VOLKE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31690 W 12 MILE RD STE 102
FARMINGTON HILLS MI
48334-4404
US

IV. Provider business mailing address

19167 SANDPIPER DR
MACOMB MI
48044-1228
US

V. Phone/Fax

Practice location:
  • Phone: 248-328-2939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704330275
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704330275
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: