Provider Demographics
NPI:1598818213
Name:TROTTER, ORAKAE MASON (RN)
Entity Type:Individual
Prefix:
First Name:ORAKAE
Middle Name:MASON
Last Name:TROTTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ORAKAE
Other - Middle Name:M
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4312 MCILWAINE DR
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23803-9412
Mailing Address - Country:US
Mailing Address - Phone:804-862-8003
Mailing Address - Fax:804-863-4049
Practice Address - Street 1:20 W BANK ST
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23803-3279
Practice Address - Country:US
Practice Address - Phone:804-862-8003
Practice Address - Fax:804-863-4049
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001184144163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health