Provider Demographics
NPI:1750832390
Name:AKINS, VICTORIA ROBBINS (PA)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ROBBINS
Last Name:AKINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:ANNE
Other - Last Name:ROBBINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:6738 STATE HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63736-8238
Mailing Address - Country:US
Mailing Address - Phone:573-313-2500
Mailing Address - Fax:573-313-2505
Practice Address - Street 1:421 SEMO DR
Practice Address - Street 2:
Practice Address - City:NEW MADRID
Practice Address - State:MO
Practice Address - Zip Code:63869-1733
Practice Address - Country:US
Practice Address - Phone:573-748-2592
Practice Address - Fax:573-748-2673
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016034584363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant