Provider Demographics
NPI:1952461147
Name:ARBUCKLE, PATRICIA DIANE (RN, BSN, MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:DIANE
Last Name:ARBUCKLE
Suffix:
Gender:F
Credentials:RN, BSN, MSN, FNP-C
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:1700 LOVETTS POND LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-1146
Mailing Address - Country:US
Mailing Address - Phone:757-739-1146
Mailing Address - Fax:
Practice Address - Street 1:4660 HAYGOOD RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-5436
Practice Address - Country:US
Practice Address - Phone:757-460-0243
Practice Address - Fax:757-460-1011
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164142363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP29386Medicare UPIN