Healthcare Provider Details

I. General information

NPI: 1205949229
Provider Name (Legal Business Name): VICTORIA PURSLEY N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CANDLEWOOD LN APT 1-8
DENNIS PORT MA
02639-1334
US

IV. Provider business mailing address

12 CANDLEWOOD LN APT 1-8
DENNIS PORT MA
02639-1334
US

V. Phone/Fax

Practice location:
  • Phone: 508-292-6022
  • Fax:
Mailing address:
  • Phone: 508-292-6022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number133956
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number133956
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number133956
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: