Provider Demographics
NPI:1346514452
Name:HEWITT, VIRGINIA KAY (MS, RN, CPNP-PC)
Entity Type:Individual
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First Name:VIRGINIA
Middle Name:KAY
Last Name:HEWITT
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Gender:F
Credentials:MS, RN, CPNP-PC
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Mailing Address - Street 1:4200 S LAKE FOREST DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7346
Mailing Address - Country:US
Mailing Address - Phone:214-592-0356
Mailing Address - Fax:214-504-9385
Practice Address - Street 1:4200 S LAKE FOREST DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7346
Practice Address - Country:US
Practice Address - Phone:214-592-0356
Practice Address - Fax:214-504-9385
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-07
Last Update Date:2016-03-23
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Provider Licenses
StateLicense IDTaxonomies
TX595111363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX301222108Medicaid