Provider Demographics
NPI:1104214725
Name:VOLK, BETTINA (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:BETTINA
Middle Name:
Last Name:VOLK
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 GEORGE DIETER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7420
Mailing Address - Country:US
Mailing Address - Phone:915-591-7704
Mailing Address - Fax:915-591-7734
Practice Address - Street 1:1390 GEORGE DIETER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7420
Practice Address - Country:US
Practice Address - Phone:915-591-7704
Practice Address - Fax:915-591-7734
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127137364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics