Provider Demographics
NPI:1922057272
Name:SAWHILL, VICTORIA (NP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SAWHILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MANISTEE
Mailing Address - State:MI
Mailing Address - Zip Code:49660-1233
Mailing Address - Country:US
Mailing Address - Phone:231-723-9190
Mailing Address - Fax:231-723-9191
Practice Address - Street 1:110 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MANISTEE
Practice Address - State:MI
Practice Address - Zip Code:49660-1233
Practice Address - Country:US
Practice Address - Phone:231-723-9190
Practice Address - Fax:231-723-9191
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704103315363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S86434Medicare UPIN
N87230001Medicare ID - Type Unspecified