Provider Demographics
NPI:1700243946
Name:VOLTIN, CONNIE (FNP)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:VOLTIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1952 REDSTONE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-9720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3501 MACCORKLE AVE SE
Practice Address - Street 2:337
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1419
Practice Address - Country:US
Practice Address - Phone:412-307-4609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV39510363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily