Provider Demographics
NPI:1255474995
Name:VOLK, LOUISE MARIE (ARRN,PMH)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:MARIE
Last Name:VOLK
Suffix:
Gender:F
Credentials:ARRN,PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 KILKEEL CT
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1806
Mailing Address - Country:US
Mailing Address - Phone:703-938-3728
Mailing Address - Fax:
Practice Address - Street 1:932 HUNGERFORD DR STE 37A
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1753
Practice Address - Country:US
Practice Address - Phone:301-294-3106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC000146363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD490964Medicare ID - Type Unspecified