Provider Demographics
NPI:1932166881
Name:VOLATILE, SANDEE M (CRNP)
Entity Type:Individual
Prefix:
First Name:SANDEE
Middle Name:M
Last Name:VOLATILE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SANDEE
Other - Middle Name:
Other - Last Name:CATTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1910 ROSELAND BLVD
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-4246
Mailing Address - Country:US
Mailing Address - Phone:903-533-0644
Mailing Address - Fax:903-533-0644
Practice Address - Street 1:1910 ROSELAND BLVD
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-4246
Practice Address - Country:US
Practice Address - Phone:903-533-0644
Practice Address - Fax:903-533-0644
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000220363LP2300X
TXAP116167363L00000X
TX741573363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J7892OtherMEDICARE/PTAN
TX8Y2104OtherBCBS
DES60400Medicare UPIN
TXP00447253Medicare PIN
TX8J7892Medicare Oscar/Certification