Provider Demographics
NPI:1275180259
Name:LARKIN, VICTORIA PATRICIA
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:PATRICIA
Last Name:LARKIN
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 1:19110 E PARK ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64058-1371
Mailing Address - Country:US
Mailing Address - Phone:816-796-6655
Mailing Address - Fax:
Practice Address - Street 1:19110 E PARK ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64058-1371
Practice Address - Country:US
Practice Address - Phone:816-796-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider