Healthcare Provider Details

I. General information

NPI: 1245163401
Provider Name (Legal Business Name): VICTORIA REBECCA MEDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 NW 8TH ST APT A2
GRIMES IA
50111-1027
US

IV. Provider business mailing address

207 NW 8TH ST APT A2
GRIMES IA
50111-1027
US

V. Phone/Fax

Practice location:
  • Phone: 425-567-8262
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberN25104055
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: