Provider Demographics
NPI:1326639865
Name:AGYEKUM, VICTORIA M (RN)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:M
Last Name:AGYEKUM
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 1:10500 ABERCORN ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-1109
Mailing Address - Country:US
Mailing Address - Phone:877-225-0316
Mailing Address - Fax:
Practice Address - Street 1:10500 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1109
Practice Address - Country:US
Practice Address - Phone:877-225-0316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN041433163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical