Provider Demographics
NPI:1225359862
Name:FISCHENICH, VICTORINA N (GNP-BC)
Entity Type:Individual
Prefix:
First Name:VICTORINA
Middle Name:N
Last Name:FISCHENICH
Suffix:
Gender:F
Credentials:GNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 OXFORD AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1025
Mailing Address - Country:US
Mailing Address - Phone:806-793-8869
Mailing Address - Fax:806-793-0043
Practice Address - Street 1:2002 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1025
Practice Address - Country:US
Practice Address - Phone:806-793-8869
Practice Address - Fax:806-793-0043
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX733654363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology