Mansfield, Victoria

Mansfield, Victoria is an individual health care provider with primary practice located at 2670 Mcingvale Rd Ste J , Hernando MS 38632-8696. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Mansfield, Victoria can be contacted via phone (901) 259-1600.

Contact Information

Primary practice address
2670 Mcingvale Rd Ste J Hernando MS 38632-8696
Phone: (901) 259-1600
Fax: (901) 259-1698
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA00419 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 3785 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA00419 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 3785 Tennessee

Profile Details

NPI number 1255895017
LBN Legal business name Mansfield, Victoria
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2019
Last updated Apr 17th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255895017 NPPES
Mississippi Other PA00419 MS LICENSE
Mississippi Other 3785 MS LICENSE

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