Healthcare Provider Details

I. General information

NPI: 1366016701
Provider Name (Legal Business Name): VICTORIA GELB FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 05/19/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 NORTHWESTERN AVE STE 1100
WEST LAFAYETTE IN
47906-1332
US

IV. Provider business mailing address

2215 PLANK RD # 249
FREDERICKSBURG VA
22401-5226
US

V. Phone/Fax

Practice location:
  • Phone: 540-424-9901
  • Fax:
Mailing address:
  • Phone: 540-424-9901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0001231969
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: