Provider Demographics
NPI:1295331429
Name:DENNIS, VICTORIA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MARIE
Last Name:DENNIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 HUNTERS RDG
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-8110
Mailing Address - Country:US
Mailing Address - Phone:330-651-0053
Mailing Address - Fax:
Practice Address - Street 1:735 NILES CORTLAND RD SE STE 2
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2475
Practice Address - Country:US
Practice Address - Phone:330-856-6365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027798363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily