Healthcare Provider Details

I. General information

NPI: 1821189549
Provider Name (Legal Business Name): VICTORIA LYNN PITCHFORD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7229 CLEARVISTA DRIVE
INDIANAPOLIS IN
46256-1698
US

IV. Provider business mailing address

9894 EAST 121ST STREET
FISHERS IN
46037-0000
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-4300
  • Fax: 317-621-4301
Mailing address:
  • Phone: 317-621-4800
  • Fax: 317-621-4700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71001931A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: