Provider Demographics
NPI:1063043404
Name:VOLLEN, JACOB (PA-C)
Entity Type:Individual
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First Name:JACOB
Middle Name:
Last Name:VOLLEN
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:FAA TECHNICAL CENTER, BUILDING 350
Mailing Address - Street 2:ATTENTION: MEDICAL
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234
Mailing Address - Country:US
Mailing Address - Phone:609-577-2007
Mailing Address - Fax:609-677-2143
Practice Address - Street 1:FAA TECHNICAL CENTER, BUILDING 350
Practice Address - Street 2:ATTENTION: MEDICAL
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234
Practice Address - Country:US
Practice Address - Phone:609-577-2007
Practice Address - Fax:609-677-2143
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2023-07-24
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant