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General NPI Number Information
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NPI Number | 1942783717
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Entity Type | Individual
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Provider Name | PAUL ALAN VOLSTORF FNP
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Gender | Male
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Dates
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Enumeration Date | 09/07/2018
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 777 S MAIN ST
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City | CLINTON
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State | IN
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Zip | 47842-2493
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Country | US
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Telephone | 765-828-1003
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Fax |
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Provider Business Mailing Address
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Address Line | 25 CALDRON LN
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City | PARIS
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State | IL
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Zip | 61944-6595
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Country | US
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Telephone | 217-822-6422
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71008317A
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License Number State | IN
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