Provider Demographics
NPI:1316607922
Name:VOLKMAN, REAGAN ELIZABETH (N/A)
Entity type:Individual
Prefix:
First Name:REAGAN
Middle Name:ELIZABETH
Last Name:VOLKMAN
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 REDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1463
Mailing Address - Country:US
Mailing Address - Phone:701-595-3641
Mailing Address - Fax:
Practice Address - Street 1:130 REDSTONE DR
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1463
Practice Address - Country:US
Practice Address - Phone:701-595-3641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant