Provider Demographics
NPI:1164467478
Name:VOLZ, DIANE (CRNA)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:VOLZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 WHITNEY AVE
Mailing Address - Street 2:PO BOX 5576
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3209
Mailing Address - Country:US
Mailing Address - Phone:203-407-1500
Mailing Address - Fax:203-230-4794
Practice Address - Street 1:2200 WHITNEY AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3691
Practice Address - Country:US
Practice Address - Phone:203-407-1500
Practice Address - Fax:203-230-4794
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE36027163W00000X
CT000262367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered