Provider Demographics
NPI:1104209634
Name:JAMES, VICTORIA LYNN (APRN-C)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNN
Last Name:JAMES
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 N MCMULLEN BOOTH RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2008
Mailing Address - Country:US
Mailing Address - Phone:727-726-8871
Mailing Address - Fax:727-669-3243
Practice Address - Street 1:3131 N MCMULLEN BOOTH RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2008
Practice Address - Country:US
Practice Address - Phone:727-726-8871
Practice Address - Fax:727-669-3243
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9294596363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4106137OtherAETNA HEALTHCARE
FLNIWNZOtherFLORIDA BLUE
FL104632600Medicaid
FL6246533OtherCIGNA HEALTHCARE
FL6816708OtherUNITED HEALTHCARE