Provider Demographics
NPI:1881837011
Name:JAMES, VIRGINIA LOUISE (PNP)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:LOUISE
Last Name:JAMES
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11 GARVEY PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5614
Mailing Address - Country:US
Mailing Address - Phone:636-441-7280
Mailing Address - Fax:636-939-9208
Practice Address - Street 1:11 GARVEY PKWY
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5614
Practice Address - Country:US
Practice Address - Phone:636-441-7280
Practice Address - Fax:636-939-9208
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001017766363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420003495Medicaid