Provider Demographics
NPI:1578060133
Name:KREINER, VIRGINIA MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:MARIE
Last Name:KREINER
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 1:3573 STATE HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLYMOUTH
Mailing Address - State:NY
Mailing Address - Zip Code:13844-6811
Mailing Address - Country:US
Mailing Address - Phone:607-336-5984
Mailing Address - Fax:
Practice Address - Street 1:3573 STATE HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:SOUTH PLYMOUTH
Practice Address - State:NY
Practice Address - Zip Code:13844-6811
Practice Address - Country:US
Practice Address - Phone:607-336-5984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY634374163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse