Provider Demographics
NPI:1073995536
Name:NEUSES, VICTORIA
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:NEUSES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6845 E US HIGHWAY 36 STE 500
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-9781
Mailing Address - Country:US
Mailing Address - Phone:847-548-9425
Mailing Address - Fax:
Practice Address - Street 1:6845 E US HIGHWAY 36 STE 500
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9781
Practice Address - Country:US
Practice Address - Phone:317-742-1340
Practice Address - Fax:317-203-1066
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71012862A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health