Doctor Name: | VICTORIA M VENTURELLA |
NPI Number: | 1750625562 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | 5005921 |
Business Practice Address: | 310 N Halleck St Demotte, IN - 463109419 |
Business Phone Number: | 8663892727 |
Business Fax Number: | |
Mailing Address: | 11001 Deer Creek Dr, CROWN POINT |
State: | IN |
Postal Code: | 463077141 |
Phone Number: | 3128481410 |
Fax Number: | |
NPI Enumeration Date: | 11/16/2012 |
NPI Last Update Date: | 06/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5005921 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |