Provider Demographics
NPI:1295357762
Name:PALMER-ERBS, VICTORIA K (PHD, RN, PMHCNS-BC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:K
Last Name:PALMER-ERBS
Suffix:
Gender:F
Credentials:PHD, RN, PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 COOLIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-7736
Mailing Address - Country:US
Mailing Address - Phone:781-439-3871
Mailing Address - Fax:
Practice Address - Street 1:21 COOLIDGE RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-7736
Practice Address - Country:US
Practice Address - Phone:781-439-3871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN122196163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN122196OtherNON-BILLING MASSHEALTH PROVIDER