Individual
JENNIFER JOHNSON VOLLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-1935
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110001172
VA
363A00000X
Physician Assistant
Primary
2676
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010134099
—
VA
05
—
1124111083
—
VA
01
—
P00810122
RR MEDICARE
VA
Enumeration date
10/02/2006
Last updated
11/08/2017
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