Provider Demographics
NPI:1518506021
Name:CODY, VICTORIA RENEE (PCT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:RENEE
Last Name:CODY
Suffix:
Gender:F
Credentials:PCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3034 N 37TH ST APT 9
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7033
Mailing Address - Country:US
Mailing Address - Phone:602-412-7855
Mailing Address - Fax:
Practice Address - Street 1:3034 N 37TH ST APT 9
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7033
Practice Address - Country:US
Practice Address - Phone:602-412-7855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-31
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No251E00000XAgenciesHome Health