Provider Demographics
NPI:1417505207
Name:AGBAR, VICTORIA (RN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:AGBAR
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 1:9208 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3214
Mailing Address - Country:US
Mailing Address - Phone:202-316-3391
Mailing Address - Fax:
Practice Address - Street 1:6704 TERRA ALTA DR
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3748
Practice Address - Country:US
Practice Address - Phone:240-716-2320
Practice Address - Fax:301-552-2453
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR4278163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care