Provider Demographics
NPI:1457798928
Name:RESNIK, VIRGINIA M (RN)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:M
Last Name:RESNIK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 VERMONT ROUTE 100
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:VT
Mailing Address - Zip Code:05748-9763
Mailing Address - Country:US
Mailing Address - Phone:802-767-1111
Mailing Address - Fax:
Practice Address - Street 1:262 VERMONT ROUTE 100
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:VT
Practice Address - Zip Code:05748-9763
Practice Address - Country:US
Practice Address - Phone:802-767-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH062875-21163WC0400X, 163WH1000X, 163WM0705X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH062875-21OtherREGISTERED NURSE