Provider Demographics
NPI:1891059028
Name:MEYER, VICTORIA J (RN, CHPN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:J
Last Name:MEYER
Suffix:
Gender:F
Credentials:RN, CHPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:PORTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14770-0226
Mailing Address - Country:US
Mailing Address - Phone:716-933-7099
Mailing Address - Fax:
Practice Address - Street 1:36 TEMPLE ST
Practice Address - Street 2:
Practice Address - City:PORTVILLE
Practice Address - State:NY
Practice Address - Zip Code:14770
Practice Address - Country:US
Practice Address - Phone:716-933-7099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN546490163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse