Healthcare Provider Details

I. General information

NPI: 1447216551
Provider Name (Legal Business Name): DIANE MARY VOELKER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 CONNELLY D R
JEFFERSON WI
53549
US

IV. Provider business mailing address

W5201 NAVAN RD
WATERTOWN WI
53094-9152
US

V. Phone/Fax

Practice location:
  • Phone: 920-674-6190
  • Fax:
Mailing address:
  • Phone: 920-262-7394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number67405-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: