Provider Demographics
NPI:1245382720
Name:STUFFLET, VIRGINIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:
Last Name:STUFFLET
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 FAWN DR
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-9734
Mailing Address - Country:US
Mailing Address - Phone:610-796-7425
Mailing Address - Fax:610-376-6944
Practice Address - Street 1:230 N 5TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3309
Practice Address - Country:US
Practice Address - Phone:610-376-6077
Practice Address - Fax:610-376-6944
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN347306L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016129970001Medicaid