Provider Demographics
NPI:1578803656
Name:ST.VICTOR, THELMA B (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:THELMA
Middle Name:B
Last Name:ST.VICTOR
Suffix:
Gender:F
Credentials:FNP-BC
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6635 W HAPPY VALLEY RD STE A104-621
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-2609
Mailing Address - Country:US
Mailing Address - Phone:602-358-7073
Mailing Address - Fax:888-927-0409
Practice Address - Street 1:40 N SWAN RD STE 118
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3019
Practice Address - Country:US
Practice Address - Phone:602-358-7073
Practice Address - Fax:888-927-0409
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ285756363LF0000X
NYF3368901363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily