Provider Demographics
NPI:1629604202
Name:BUCHANAN, VICTORIA REBECCA (CNM)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:REBECCA
Last Name:BUCHANAN
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Gender:F
Credentials:CNM
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4000 COLISEUM DR STE 280
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5974
Mailing Address - Country:US
Mailing Address - Phone:757-827-2455
Mailing Address - Fax:757-452-5773
Practice Address - Street 1:4000 COLISEUM DR STE 280
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5974
Practice Address - Country:US
Practice Address - Phone:757-827-2455
Practice Address - Fax:757-452-5773
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2023-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024178841367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife