Provider Demographics
NPI:1811388226
Name:JOURNIGAN, VICTORIA GAIL
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:GAIL
Last Name:JOURNIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:GAIL
Other - Last Name:GOSNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:218 LANSBURY DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-1951
Mailing Address - Country:US
Mailing Address - Phone:434-489-2725
Mailing Address - Fax:
Practice Address - Street 1:155 HOLT GARRISON PKWY
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-5947
Practice Address - Country:US
Practice Address - Phone:434-799-9951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-07
Last Update Date:2015-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230000520183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician