Provider Demographics
NPI:1508248634
Name:FOXELL, VICTORIA (RN-FNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:FOXELL
Suffix:
Gender:F
Credentials:RN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N ESPLANADE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CUERO
Mailing Address - State:TX
Mailing Address - Zip Code:77954-4727
Mailing Address - Country:US
Mailing Address - Phone:361-275-3466
Mailing Address - Fax:361-275-3460
Practice Address - Street 1:2500 N ESPLANADE ST STE 102
Practice Address - Street 2:
Practice Address - City:CUERO
Practice Address - State:TX
Practice Address - Zip Code:77954-4727
Practice Address - Country:US
Practice Address - Phone:361-275-3466
Practice Address - Fax:361-275-3460
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128343363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX441928YK7YMedicare PIN