Provider Demographics
NPI:1790752749
Name:VIGNA, PATRICIA P (MSN, APNC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:P
Last Name:VIGNA
Suffix:
Gender:F
Credentials:MSN, APNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 STATE ROUTE 33
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07754-0397
Mailing Address - Country:US
Mailing Address - Phone:732-776-4430
Mailing Address - Fax:732-776-4337
Practice Address - Street 1:1945 STATE ROUTE 33
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07754-0397
Practice Address - Country:US
Practice Address - Phone:732-776-4430
Practice Address - Fax:732-776-4337
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05498600363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP02172Medicare UPIN
NJ036211TDAMedicare ID - Type Unspecified