1669529814 NPI number — VALERIE DANEEN VOLLMAN LOTR, CHT

Table of content: VALERIE DANEEN VOLLMAN LOTR, CHT (NPI 1669529814)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669529814 NPI number — VALERIE DANEEN VOLLMAN LOTR, CHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VOLLMAN
Provider First Name:
VALERIE
Provider Middle Name:
DANEEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LOTR, CHT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CUSHMAN
Provider Other First Name:
VALERIE
Provider Other Middle Name:
DANEEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LOTR
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669529814
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 BELLE CHASSE HWY
Provider Second Line Business Mailing Address:
SUITE I
Provider Business Mailing Address City Name:
TERRYTOWN
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70056-7156
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-391-7670
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 BELLE CHASSE HWY
Provider Second Line Business Practice Location Address:
SUITE I
Provider Business Practice Location Address City Name:
TERRYTOWN
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70056-7156
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-391-7670
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X , with the licence number:  Z11630 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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