Provider Demographics
NPI:1245238450
Name:VOLPE, JENNIE M (PA)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:M
Last Name:VOLPE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 UP RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78408-3020
Mailing Address - Country:US
Mailing Address - Phone:361-882-1001
Mailing Address - Fax:361-882-1040
Practice Address - Street 1:3933 UP RIVER RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78408-3020
Practice Address - Country:US
Practice Address - Phone:361-882-1001
Practice Address - Fax:361-882-1040
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03004363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX156989901Medicaid
TXP31331Medicare UPIN
TX156989901Medicaid