Provider Demographics
NPI:1255670659
Name:SMITH, VIRGINIA MARGARET (RN)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:MARGARET
Last Name:SMITH
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 1:130 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ELBRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:13060
Mailing Address - Country:US
Mailing Address - Phone:315-689-8500
Mailing Address - Fax:
Practice Address - Street 1:130 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:ELBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:13060-0170
Practice Address - Country:US
Practice Address - Phone:315-689-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY451540163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool