Provider Demographics
NPI:1942908157
Name:MASSEH, VIRGINIE NOELLE
Entity Type:Individual
Prefix:
First Name:VIRGINIE
Middle Name:NOELLE
Last Name:MASSEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20313 THE GDNS APT 301
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6779
Mailing Address - Country:US
Mailing Address - Phone:240-764-9233
Mailing Address - Fax:
Practice Address - Street 1:20313 THE GDNS APT 301
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6779
Practice Address - Country:US
Practice Address - Phone:240-764-9233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR224286363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health