Provider Demographics
NPI:1568421535
Name:PILCHER, MARY JUDITH (WHP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JUDITH
Last Name:PILCHER
Suffix:
Gender:F
Credentials:WHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 836
Mailing Address - Street 2:
Mailing Address - City:NASSAWADOX
Mailing Address - State:VA
Mailing Address - Zip Code:23413-0836
Mailing Address - Country:US
Mailing Address - Phone:757-442-6719
Mailing Address - Fax:757-442-7375
Practice Address - Street 1:10243 ROGERS DRIVE
Practice Address - Street 2:
Practice Address - City:NASSAWADOX
Practice Address - State:VA
Practice Address - Zip Code:23413
Practice Address - Country:US
Practice Address - Phone:757-442-6719
Practice Address - Fax:757-442-7375
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024090211363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00024353Medicare ID - Type Unspecified
VAR60357Medicare UPIN